Illness Update #47827

I guess I should update for posterity sake, and for those of you reading along that I don’t know or see regularly “in real life”.

Last Monday, Nolan woke up pouring thick green snot out of each nostril like dueling fountains. That’s all, though – no wheezing, no retractions, no coughing. We thanked God for the advent of Pulmicort (did I ever even update here that he’s on a daily regimen now? I’ve lost track), for changing our lives now with a second respiratory kid. That’s still true, but it wouldn’t be foolproof forever.

On Friday, he woke up the worst I had seen him. Not doing much of anything while he used his whole body to work to breathe. Retractions as severe as Elise got, but worse than I had seen with him thus far. I gave him albuterol which helped tremendously but not completely, so Kyle suggested I still take him to see Matt just to keep on top of things. It was at this point that I realized I have little idea what to do with this kid, despite taking care of the sickest respiratory kids in the city for a living – and my own child already once, too. He’s just, as Matt aptly put it, shades of grey. Elise was severely ill quickly, with great predictability, and always responded beautifully to treatment. Nolan is inconsistent at best, both in exacerbations to various expected triggers and to the completeness of his response. But I digress…

I took him into the office later that morning, where he was already very clearly working off the treatment a bit before another was due. His oxygen saturation was hovering just above hypoxia, which was new. And then when Matt listened to Nolan, he was convinced he actually had some atelectasis. Instead of waiting it out, he started him on oral steroids (again) to help his lungs heal and got a chest X-ray to confirm exactly what was going on. We will likely increase to twice daily Pulmicort after the round of Orapred, in hopes to keep this cycle broken. I hate that he’s got all of this going on already, while he is so little. Maybe it means he’ll grow out of it early? Too optimistic?

In related news, Nolan got a routine blood draw earlier in the same week. He watched as the phlebotomist tied the tourniquet, watched her stick him, watched the blood fill the tubes, then looked at her and smiled his heart-melting smile. Freaking cool kid, I tell you 🙂 Meanwhile, I got yelled at by the big sisters who had been cowering in the corner: “Why didn’t you tell me he wouldn’t cry at all?! I wouldn’t have freaked out!” My kids are all the best. 🙂

And in a final piece of related news, Elise also has strep. Much like with her recent ear infections, there was barely a complaint.

We are actually less burdened by all this than it might seem, mostly because we have no choice – life moves on around us. I’m thankful for resilient kids, a supportive husband, good medicine, a great doctor… and spring, which better freaking be around the corner. 🙂