Serious Run-In with RSV

This morning, I lived through every mother's worst nightmare. Roo stopped breathing and I had to call 911 while he was limp and turning blue right in front of me.

The day started normally. As Mike and Merrit got in the car (Mike drops Merrit off at preschool on his way into work), I said goodbye and decided that I wasn't going to go to the gym today because Roo has had a mild cough and I felt like he needed his rest. (That was the first of many protections that God had laid out for us in the day ahead.)

I fed Roo at about 9:30 and he dozed off, so I put him in his bouncy seat and went to get dressed, fix my hair, and put on my makeup. About 20 minutes later, he woke up and was fussy so I picked him up and put him in my sling. (Another blessing...he was with me when it happened.) He was content and was quietly sleeping while I checked my email until about 10:30.

That's when Roo woke up with a start and seemed to be retching, like he needed to throw up. I pulled him out of the sling and leaned him forward and he suddenly just went completely limp. Still holding him, I turned him around and looked at him and he was completely lifeless, and starting to turn blue around the lips.

This is hard to even write...I was so scared...I just thank God that Roo is okay and that I'm writing this story with the knowledge that he is okay!!!

So, anyway, I was calling his name and rubbing his head and face. Nothing. I started praying. I grabbed him by the ankles and swung him upside down. Slapped the bottoms of his feet. Nothing. I grabbed the phone and called 911.

The operator dispatched the emergency services and asked me how old the baby was, how long he'd been without oxygen, and a few other questions that I just can't remember. She told me to lie him down on a hard surface and tilt his head back to look for an object in his airway. I think she asked me if he'd had any seizure-like activity. Right about that time, as I was kneeling over him on the dining room floor, I heard the EMS pull up in the driveway. Just then, Roo took a huge gasp in and opened his eyes really wide. Then he started wailing and crying very loudly. I told the operator that he was breathing; she could hear him crying, too. And I told her that the paramedics were at the door.

I went to the door with Roo in my arms and the 911 operator still on the phone. She said we could hang up now that help had arrived. The early responders were here in less than two minutes and the ambulance from the hospital was here about 10 minutes later. During the interval, the early responders put Roo on an oxygen mask and a pulse oximeter. They asked me a lot of questions, too. Roo just kept crying, which was reassuring to hear. I guess he was really scared....all the activity, the strange guys holding him, the mask over his face, the anxiety in the air.

I called Mike. I didn't really know what to tell him yet except that we were going to be taking the ambulance to the hospital and could he pick up Merrit from preschool. He left work right away.

On the way to the hospital, I wanted to nurse Roo to calm and comfort him. (He had been given an IV in his foot and was upset and crying from that.) As he nursed, he stopped breathing again. The EMT stimulated him and he came right back, but not until she and I both watched his heart rate dip down to 50 (it should be between 120 and 160). She said something to the driver and they turned the sirens on and sped up to get us to the hospital more quickly.

At the Hospital
Once we got to the pediatric emergency room, the doctors started another I.V. in his right hand because the one in his foot wasn't flushing and they had to take it out. Thankfully, they got it on the first try. In addition to the I.V. , they put in a high-flow nasal cannula, which forced oxygen into his nose to kind of "force him" to keep breathing. A respiratory therapist also collected a sample of mucous from Roo's nose with a suction catheter (which he didn't like at all) so that the lab could run an RSV test. Roo was fighting all this stuff the whole time, of course. I guess it's only natural. And you can't tell him that they're trying to help.

I was having some major flashbacks to everything that we went through with Merrit when he was a baby. It is so hard to watch your baby crying and fighting when you're the mom and there's just nothing you can do except stroke his head and talk to him!

Things settled down a bit and Roo and I had just had a few minutes to catch our breath when Mike and Merrit came in (it was already 1:30 by this time). Roo seemed to be doing better, which was a relief for all of us. Mike and I spent some time together, going over what had happened and comforting each other and Roo.

We still hadn't heard whether this was RSV or not, but the docs suspected that that's what it was. Unfortunately, by this time, the I.V. in Roo's hand had come out, so they wanted to put in another one. Mike and I didn't think Merrit should watch that, so the boys left for home.

A new nurse came in and tried THREE TIMES -- the left hand and both elbows -- to hit a vein, all while Roo cried and struggled. It was pretty horrible, especially when it was all for nothing. She'd blown three veins and he still didn't have an I.V.! They sent in the nurse who'd successfully put the I.V. in first and she had no choice but to go back to the right hand and try to hit it a little higher up from where the first catheter had been. She got it in, thankfully, and they splinted and taped that arm well to keep the I.V. from coming out again. Next, they needed a urine sample, so they came in to catheterize him. That was painful for him, too.

When all that was over, Roo was exhausted. Since he hadn't eaten since the ambulance ride, I asked the doctor if it was okay to feed him and she said yes. While he was nursing, his heart rate dipped again. I heard it beeping slower so I looked up at the monitor and saw it dropping down to 90, 80, 70. I yelled for the nurse and started stimulating Roo by poking his chest pretty hard, like I'd seen the EMT do in the ambulance. He woke up just as the nurse came in and we watched his heart rate rise again.

Over the next half hour as I held him in my lap (not nursing him now), he did it four more times. He had his shirt off and I could see his chest stop moving. Two nurses stayed in the room with me as we watched it happen over and over, prodding him each time to wake him up.

The pediatric doctor who'd been with us all day came in and said that this seemed awfully serious for RSV and suggested that, while we wait for the RSV results, we do a CAT scan and a spinal tap to rule out other more serious things like brain injury, seizure activity, or meningitis. He also said that he was worried about Roo's airway and that we might be looking at intubating him and putting him on a ventilator if he kept having these episodes. I asked about the RSV results...when would we have them back? Soon, he said. So I asked if we could just delay more procedures that would be painful for Roo until we got the results back. He agreed.

I don't know how much time passed with me watching Ollie's chest and counting his breaths. For a few minutes there I just kind of lost it. My mind started racing and it got away from me a little...I was just kind of thinking that I really didn't know what the worst thing that might happen was. I imagined that the next time he stopped breathing, what if they couldn't bring him back? What if they stood there trying to resuscitate him over and over and then they couldn't do it? How would I tell Mike? How could I possibly find the words to explain what had happened to Merrit? I started shaking and crying and pushed the nurse's call button...I just couldn't be alone in the room. I also called and asked Mike to please come back to the hospital. We had to arrange for someone to watch Merrit for the afternoon and our wonderful friend Melissa didn't hesitate. (We are so blessed with good friends!)

Mike got to the hospital and just after he got there, we got the results back from the RSV test. Yes, that's what Roo had. It's surprising to me that RSV can cause such severe apnea like that! I had no idea! Later this evening, I found this info from the Johns Hopkins website about RSV and apnea in infants:

Acute complications in infants include apnea and respiratory failure. Apnea, as a result of RSV infection, most commonly presents in the first 1-2 months of age, in premature infants and in infants exhibiting moderate to severe hypoxemia. There is limited evidence that RSV may contribute to the occurrence of sudden infant death syndrome (SIDS) in infants older than 3 months of age.

Moved to the PICU, Spending the Night
By about 6:30 or 7:00, we were moved from the E.R. to the pediatric intensive care unit (PICU). At this point, Ollie was getting I.V. fluids and was still on the high-flow oxygen. They'd also given him some intravenous caffeine to keep him stimulated and breathing. His last episode of apnea had been at 3:30, so things were calming down a bit.

Again, it's so weird. Besides a very mild cough, this does not seem like a sick child. At this point, we're just going to spend the night here in the PICU to observe him. He's on a pulse oximeter and monitors that register his respiration rate and his heart rate. The nurses will come in during the night (every four hours) and check his temperature and blood pressure. And we'll just pray that Ollie gets good sleep and continues to improve from here.

The doctors tell us that RSV will run its course in seven to 10 days and that the fourth or fifth days are typically the worst. We figure Roo's cough and overall fussiness started on Saturday (it's Tuesday now), so maybe we're over the hump and have seen the worst of it.