05 April, 2010

The Saddest Thing

I didn't want to blog about what happened for the past 3 weeks. But then blogging it will be a reminder to me and a warning to all that we sometimes just cannot take things for granted.

It all started right after Jayden's birthday.

Have I been overindulging him in eating unhealthy snacks and drinking too much fizzy drinks over the past 2 days of his birthday celebration? Or did he caught the Streptoccus pneumoniae from Daddy who just came back from UK? Or was he infected when we first visited the PD on Monday when he had high fever? And the teachers were also very concerned if he had caught the bug in school and was hibernating in his body over the past few days before the high fever hit him?

I have no answers.

I was very angry with myself. How on earth did I let it happened? Of course nobody wants Jayden to be hospitalized but it can be avoided. How? By not waiting and be more prudent about going to the hospital or doctor earlier when the kid shows signs of distress.

14 March, Sunday
realized the kid was running a temperature. Gave him a dose of paracetamol.
fever did not subside and temperature was going up to 39 degrees. Called the PD and asked if I could give him a dose of Bifen. Fever subsided after taking Bifen. Monitored temperature every 2 hourly.

15 March, Monday
Brought him to the PD to make sure that it's nothing more than viral fever (which I can handle). There were a few kids in the clinic coughing and sneezing. I can see some of them were having fever as well. PD said it's viral fever which will take at least 4 days for the fever to go away. Was given extra bottles of Paracetamol and Bifen to standby. He was still active whenever the fever subsided.

Jayden started coughing. High fever persisted.

16 March, Tuesday
Cough seems to worsen and fever persisted further. I decided to bring him back to the PD tomorrow morning. Still active whenever the fever subsides.

17 March, Wednesday
Back to the PD. A few kids were coughing. Some had to go on the neubrilizer. PD listened to Jayden's chest and decided to start him on the antibiotics. I'm not in favor of starting the kid on antibiotics because he will start to have diarrhoea and lost of appetite. But nevertheless PD said it's necessary with at least 1 dose a day. PD advised to do a remote consultation via phone on Saturday morning to check on Jayden's condition. Showing signs of lethargic, not to mention that his appetite started to drop.

18 March, Thursday
The cough seems to have worsen. But Ed and I decided to wait for a day before taking further actions as Jayden just started on the antibiotics. If I were bring him back to the PD, she would probably say that I'm being paranoid and too kiasu. High fever persisted and not eating much at all. He was still able to play a little whenever the fever subsides.

19 March, Friday
Cough worsen. Jayden was totally not playing and talking much the whole day. He was constantly drifting into sleep and then waking up coughing badly. He didn't want to lie down to sleep, insisted on sitting up straight. He was not eating much but kept asking for water. He was gasping to breath at times.

Decided not to wait any longer and went to KK Hospital.
All that happened after was like a blur dream. I got off at the drive way of the hospital while Ed went to get the car parked. There was no queue for the children's A&E and Jayden was being attended to immediately. The nurse did a quick check on Jayden's stats and immediately we were ushered into another room.

I was puzzled. The nurse quickly gave the stats to the doctors and the nurses in the room. Very quickly one of the nurse put a oxygen mask over Jayden's mouth to help him with his breathing. I was stunned and scared. I quickly asked the nurse who was attending to Jayden if he's gonna be alright. The nurse didn't answer me but keep looking at the machine which was monitoring Jayden's pulse rate, % of oxygen that he's taking and respiratory rate.

I was stunned, shocked and scared and tears started to well in my eyes. We waited too long. We should brought him in earlier and he wouldn't be subjected to all these pain and distress.

A chest x-ray was ordered immediately and the result showed that Jayden's right lung was badly infected and solidified. Preliminary examination by the doctor stated that he had pneumonia. The worse scenario is that Jayden may have to go through surgery to have his infected part of the lung removed. Another less damaging alternative was to insert a chest tube to drain out all the fluid that is now affecting his chest and outside of the lungs to ease his breathing.

Jayden had to be admitted to High Dependency ward because his condition had to be monitored round the clock. I was shocked when we arrived at the ward because there are other 4 kids in the ward with their accompanied parent there. It was quite a crowd with the additional nurses and doctors who were attending to Jayden. Ed requested for a 1 bedder room but was told there were no such class for the High Dependency ward as they need to centralize their resources.

Proceed to the x-ray room for a further CT scan to further evaluate to see if Jayden can evade surgery.

20 March, Saturday
CT scan shows that Jayden's right side of the lung is badly infected and solidified with fluid. After much discussion with the few doctors, it is best decided to insert a chest tube just below the surface of the of the skin, as near to the infected part of the lung as possible, to drain off as much fluid as possible. The doctors then briefed us on the side effects..... I was only half listening to what the doctors were saying. I left the rest of the discussion to Ed as I was too devastated, guilty and heart-pain.

The doctors also ordered a high pressure oxygen mask instead of the normal oxygen mask for Jayden as the former will help to Jayden to breath even easier. But the high pressure oxygen mask was very big and the pressure was high. Jayden's lips gotten dry and soon started to crack under the constant harsh blowing of oxygen from the mask.

Jayden was constantly asking if he could take the mask off... he will go "ok? done? can get it off?!"... Even though he was in distress he could still sound demanding and feisty!

Doctors and nurses continued to hover over Jayden, monitoring him as the hours passed by.

The procedure of inserting the chest tube has been ordered and will take about half and hour to complete. Jayden was heavily sedated so that he wouldn't be feeling the pain. As it was considered a minor procedure, it was carried at the ward itself with curtains drawn. Ed and I waited outside while the procedure was being carried out. They will leave the chest tube in Jayden for about 3 to 4 days so as to drain out as much fluid as possible.

Saw the chest tube attached to Jayden's small body. It was heart wrenching but inevitable. I was very concerned about the pain that he would feel after the sedation is over and I kept bugging the nurses to be on time whenever the painkiller is due. Though Jayden was heavily sedated he was still conscious about his surroundings and the pain. He kept saying "pain... pain..." and he was hungry. But because of the sedation, he was not to be given any food or water. We had to try our best to distract him. He was so desperate that he even asked for milk. Milk was the last thing he ever wanted when he was well.

The rest of the day Jayden was drifting in and out of sleep due to the effect of the sedation. Gradually he began to realized that the chest tube was there to stay.

21 March, Sunday
Ed and I took turns to go home, wash up and freshen up. Doctors came and explained Jayden's situation to us again and again. Thank goodness Jayden's condition wasn't life threatening but the infection was severe. His blood samples were taken for cultural blood test to find out what exactly was the strain of virus so as to match the right type of antibiotics to counter attack it. But the cultural test will take at least 2 days to develop so for now the doctors will have to make a nearest assumption and gave him 3 types of antibiotics that are most likely to be effective in controlling the respiratory infection, Zithromax, Augmention and Amoxicillin. A lung specialist has also been arranged to see Jayden on Monday.

22 March, Monday
A senior consultant who is also specialized in respiratory came and checked on Jayden. We asked the next course of actions and asked her many many questions and were relieved when she further assured us that Jayden will recover given time. Cultural test results showed that the strain of virus has been identified as Streptoccus pneumoniae and Amoxicillin is the effective antibiotics that will fight it. Thank goodness they now can eliminate the other 2 as Jayden was constantly having diarrhoea with ever dose of antibiotics they are giving.

The senior consultant is now assigned to Jayden as his doctor and anything concerning Jayden's condition will be directed to her. Thank goodness.... I'm getting tired of having different Registras, different consultants, different Medical Officers and Health Officers coming to check on Jayden and giving different answers to my many questions.

Ed bought a portable DVD and attached it to Jayden's cot. With the DVDs, Jayden was less bored and much distracted with the pain. Jayden was never interested in cartoons. He actually preferred TV programs like Ninja Warrior, football matches and F1 Grand Prix races. But for a circumstance like this, he was able to compromise and settle for cartoons like UP (which we both watched for umpteen times!), KungFu Panda and the animated series of Mr Bean.

23 March, Tuesday
Ed and I received smses of concerns for Jayden from family, friends and from Jayden's teacher. Many wanted to come visit but I told them no. High Dependency ward consist of other patients who have other illness. There were much viruses going around. I strongly disagree of having visitors, especially young kids (my niece wanted to come visit badly) and adults who may not be infected with the viruses but MAY BE CARRIER of the germs and may pass it on to younger children or old folks with weak immunity system.

Received sms from Jayden's favourite teacher, Ms Jasmine. She insisted to come visit as she said she misses Jayden badly and wanted to see how is he doing. 2 other teachers came along. And upon seeing Jayden with the chest tube, Ms Jasmine cannot help it but cried.

24 March, Wednesday
Jayden's fever was beginning to subside but still there were a few spikes of high temperature. He was showing signs of recovery as he was breathing much better and easier. Pressure of the oxygen mask has also been lowered as the doctors wanted to wean it off him so that he can start to have intake of food via mouth and not through tubes and drips.

Ms Jasmine came again to visit and brought along a magnifying glass (as per Jayden's request). Ms Agnes also brought along Jayden's chinese story books for him to read when he is bored.

And finally the doctor has decided to remove Jayden's chest tube as the draining of fluid is much done.

Pysiotherapist came and together we did some exercises to help Jayden to build up his confidence to breath without the oxygen mask and to also help work his lungs.

Doctors clamp his chest tube, getting ready for the removal that is scheduled at 7.30pm. A chest x-ray was taken to see all draining by the tube has been done.

Finally the doctors came and removed the chest tube. I could hear Jayden asking alot of questions and saying things like "be careful! It's painful! What are you doing?! Why are you holding the scissors? Don't cut me ok?!" Another chest x-ray was also done to make sure that the infection is under control.

Finally the chest tube is off Jayden and resulted in 2 small stitches a the right side of his chest.

25 March Thursday
Senior consultant continued to check on Jayden daily and as I have constantly been bugging her, she finally give in and allowed Jayden to be out of the High dependency ward and to be moved to a normal one!

26 March - 3 April

Now that Jayden is finally transferred to a 1 bedder room, we are able to have more privacy, space and freedom. I was able to accompany Jayden all the time. Not that I like staying in a 1 bedder room in a hospital but it's definitely better than having to share a big room with so many other patients and accompanying parent!

And the waiting game began. Everyday was a waiting game as Jayden's fever, though slowing going down, but will have some spike up during certain time of the day. For example, the whole morning it will be 37.5 degrees to 37.8 degrees, Doctors considered 38 degrees and above will it then be having a fever) and then come evening 5.30pm the temperature will go 38.5 degrees. After a dose of paracetamol, the temperature will fall below 37.5 degrees.

We just have to wait till the fever is stabilized for at least 24 hours and then switch Jayden's administering of antibiotics from intraveous to oral before he can be discharged.

3 April, Saturday
Finally. The records from the nurses' constant measuring of Jayden's temperature shows that the infection has conceded defeat. Jayden's temperature has been constant for the past 24 hours and we can now safely switch Jayden's intake of antibiotics to oral instead of giving it to him intravenously. Just in time to be home to celebrate my birthday.

The above are a few snap shots we took during the hospitalization period. A few (the cheerful looking shots) were sent via sms-es to friends, Jayden's teacher and family members so that they are being posted of Jayden's status.

I was reluctant to have the pictures taken.... as it reminded me how careless I was and because of that that, it resulted in the pain, agony and heart wrenching moments that we all had to go through.

This blog entry will always serve as a reminder to me that I will not be complacent again when the child is down and when there are signs that he is in distress. Cannot always assume that he's doing ok even after seeing the PD thrice, cannot always think that tomorrow he will be alright.

Right now, I'm just glad and grateful that we are all able to overcome the ordeal and he's slowly taking back what he has lost during the down period.

And yes we were able to celebrate my birthday at home! And what did I wish for? I bet we all know and that is for Jayden to be strong, healthy and happy. Nothing else matters.


So frightening! But you know, I would have done exactly the same thing in your situation. How could you have known it was so serious? Even the PD didn't know! You can't blame yourself for this.

Don't blame yourself, dear. The most important thing is that it was treated in time.

The little boy will grow stronger and happier under your loving care.

It must have been so draining on you! Yes, don't blame yourself - the virus was really strong & fast. Thank God Jayden is well and cheery again! :)