I am obsessed with vital signs. In my job as a nurse, the very first thing I do when I receive a patient is get a full set of vitals. That includes their heart rate, oxygen saturation, temperature and blood pressure. I don’t just get a full set, I make sure I have continuous monitoring as vital signs are a gateway into your body. One of the most important vital signs and often overlooked is oxygen saturation.
Many of my patients have no idea what that is, or means, and when they have that little clip or sticker placed on on their finger, they often think it’s just to get their heart rate. Oxygen saturation tells us how much oxygen your body is processing into your blood stream and you want that number to be in the 92 to 100% range, the higher the better, in fact I’m more comfortable with 97-100%. Anything less sends me into a full blown panic attack and that is why when my Marcus was diagnosed with asthma, it had me more scared than his allergies.
You see I know allergies, I can tackle allergies. I know the signs, I know what to do. It may sound strange that a child with ideopathic anaphylaxis has me more scared now that he has asthma. It’s true, the very idea of not being able to breath well, having shortness of breath is terrifying to me. MILLIONS of people live with asthma and that BLOWS MY MIND! Allergies is not a subtle, creeping on you, questionable disease like asthma.
Asthma is a difficult disease to diagnose. With Marcus’ history of allergies, it was always a possibility that he would get asthma as they often go hand in hand. Although never formally diagnosed, he probably had it for years but only seasonally. Every March since he was about 2 years old, for several months he would develop this wet bad cough and our doctor would give him Singulair for several months. We didn’t like Singulair. He definitely lost his cough but we noticed mood changes, hyperactivity, more aggression. Marcus on Singulair was a difficult kid sometimes but we sucked it up as he was cured of this terrible cough. It was effective and under control quickly.
This year we started the Singulair a bit earlier as his snoring had gotten worse at night time and his adenoid were grossly enlarged possibly inflamed by allergies we were told. We thought we were covered and his yearly appointment to check in with his allergist and get that prescription for Singulair was not needed.
Until this one day recently, he woke up and couldn’t stop coughing that wet cough. I dismissed it as possibly a little bit of bronchitis that his little brother had the previous week. We gave him an albuterol treatment right away which seemed to help. A few hours later the cough returned and we gave him another dose which cleared it up right away and then we headed out for the day.
It was a gorgeous day, a day meant to be spent outdoors after a long, cold and unpredictable winter. With many errands to run and holiday sales everywhere, we headed to Tanger, an outdoor outlet. The kids were having a great time, running store to store, finding coin operated vehicles here and there to entertain them amidst random games of hide and go seek and tag. Sometimes Hubs watched the kids while I ran into a store, and then we’d switch. We’d hear a few rounds of coughing but Marcus was beaming and running carefree, having fun playing with his brother and sister.
Then all of a sudden he complained that he was tired and his head hurt from coughing and his coughing, he couldn’t stop coughing and he wanted to go home. He called a time out, he never calls a time out and we knew something was wrong. We wanted to think it was just possibly that he got bronchitis from his baby brother, but it was nagging us that he his head hurt and that cough, that wet cough was just awful and I sent a panicked email to our allergist after unsuccessfully making the urgency appear to his receptionist to only get an appointment a week out. We got an appointment the very next day right after school, timed well for this scheduled mom but meant he spent the entire day coughing and suffering, unable to breath well making me feel absolutely like a horrible, horrible mother.
Right away the doctor heard the cough, whipped out his stethoscope, listening to his lungs and shook his head. There was a very audible and devastating wheezing. I asked if this was Asthma and he said, “Definitely.” The Singulair was no longer working, his disease had progressed and we set up a new plan. Gone was the Singulair and we welcomed Pulmacort into our lives with more frequent visits with Albuterol and a little prednisone to bridge the gap until the Pulmacort became therapeutic. Marcus is an amazing kid. His doctor said many kids just keep on going, they don’t call time outs. Marcus is a kid who has been through so much in his short 5 years of life, he’s in tuned with his body way more than any 5 year old should be and knew when to call a time out. His doctor was impressed.
I was devastated to know there wasn’t anything I could do immediately to make him breath better, that he would go several days breathing like this. In fact the following 2 nights after we left the doctor’s office were the most horrific and terrifying nights of my life and possibly my son’s. He started behaving like a true asthmatic kid. Around 4am he would wake us up and himself in a coughing fit he couldn’t stop. Being a nurse and a mother of an allergy kid, I’ve got stethoscopes lying around the house everywhere and the minute I placed the scope on his back, I heard the wheezing. Popping my pulse oximeter on, I got a reading of 89 which sent me into a panic attack. As fast as I could assemble, the nebulizer was started and sometimes repeated again until the wheezing stopped and the cough was more controlled. I had to keep reminding myself to give it a few days to be therapeutic but it is not an easy few days for me to watch, let alone know that my son is living and experiencing this.
Last night was better than the night before and today is looking better. The road to getting Asthma under control is slow but there is a plan. We don’t know if it’s here to stay or only during the high allergy season but it’s a strong possibility that with his allergies, this is here to stay but I’m still hopeful. I don’t know how people can live with this as a chronic disease and be okay. Tell me how do you cope?