Wednesday, May 29, 2013

An Update on Ryan

Last Friday we had a visit with a new Pulmonologist. We were referred to him when Ryan was hospitalized about a month ago. Ryan seems to have a pattern of going to the hospital every spring for respiratory issues.  We were hoping to avoid future hospital visits by doing some preventative treatments at home.  But, it wasn't to be.

Friday morning, Ryan felt just a touch warmer than usual and even looked a little flushed, even the new doctor noticed it.  However, we went to our appointment and received a great treatment plan.  We were to start doing a new medicine with an inhaler and a spacer every morning.

 (I must admit that I'm disappointed that Ryan's is just yellow.  He is lacking the adorable dog face. )

He also gave us a treatment sheet with options for when Ryan wasn't feeling good:  nebulizer treatments and steroids.  Over the weekend, Ryan was not feeling well:  low grade fever, lethargic and a little bit of a cough.

Sunday night,  his fever spiked to 104.8, but it came down with the typical treatments.  On Monday, he seemed completely well, which was a huge blessing because we had lots we had to get done that day.  Then just as I finished all that I needed it seemed to do, he started running a fever again.  By Tuesday morning, he was obviously having a lot of respiratory distress so I did as I had been instructed and called the Pulmonologist.  After describing that he had been struggling all weekend, they wanted to see him soon. 

At the doctor's office they were very worried about his low oxygen levels.  They gave him a breathing treatment and a dose of steroids.  The Dr. then made out a new more aggressive treatment plan, which included our newest toy:  an IPV machine. 

I've now started calling the IPV machine, the green beast.  In addition to it's lovely retro feel, it then has a bunch of stuff that hooks up to it.  At one end is a little mask, that goes over Ryan's nose and mouth.  It then pushes air into his lungs and nebulizes at the same time.  I have a lot to learn about this new machine. What I do know is that Ryan does not enjoy his treatment time, and it's going to be tough to do this 3 times per day when he's well.

A Respiratory Therapist brought the IPV machine to the house late Tuesday afternoon.  I had an evening nurse there that night, but Ryan was so sick by night that I didn't really want to leave him.  We got through the evening, but night time was really tough.

Ryan's oxygen levels were dipping into the low 70's.  Remember they need to be above 92 to stay off oxygen, and his baseline is 97 or higher.  All night long, I had to keep repositioning him and waking him to get his O2 levels back up.  Wednesday morning came and I turned his care over to the daytime nurse.  I had to go to a quick meeting, but while I was away I checked in on Ryan to see how he's doing. The nurse seemed to indicate that his day hadn't been normal, but it was good.

With that report, I was a bit surprised to find Ryan looking very pale and still having a lot of breathing issues.  With 2 liters of supplemental oxygen, he should be able to function at, or at least very near, 92.  I was relieved to think that the Respiratory Therapist (RT) was coming to the house.  I thought she'd definitely be able to show us all that her plants are doing.

When the RT arrived, she didn't say much about Ryan's appearance, but got busy quickly.  She tried to give an IPV treatment, but his O2 levels kept slipping down hill. She finally suggested that it was time to call Dr. Smith. When we called Dr. Smith, he said it was time to meet him at the hospital.

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