Hospitalization and Discharge

Well, Friday (October 16) was Daddy’s turn at the hospital. When I arrived Carey was pretty sore from the hospital chair and Caden was up and moving around. Carey headed out to the airport to pick up her sisters and Caden and I settled in. He played for a short time and then calmed down and surprisingly went to sleep. This allowed dad to start catching up on some work.

Carey returned about an hour an a half later with her sisters so they could see Caden. He had just been woken up so he could get his breathing treatment.

The rest of the day we got to play nurse basket upset. Caden ended up getting a new nurse every four hours, which meant I had to orientate them to Caden’s needs. Of course they all have their own preferences about how much the parents can help. It is really a little awkward since we have been providing all his care for the past six months and then we get told not to touch things. Of course I have to laugh when that is followed up with asking what needs to be done. Anyway, I ended up commenting on the constant change of nurses and I was told that due to flu season the hospital has implemented a policy that requires workers to stay home for seven days once they get sick even if they are feeling better. Hence nurses having to float around to cover. As flu season continues this may present an access problem, because this will exacerbate the healthcare worker shortage problem.

Around 5 p.m. I finally got to speak with the doctor. I asked him if we would be in the hospital all weekend, which is what I expected, but he said that as long as Caden had a good night and met certain metrics he could be released Saturday. I thought this was great news.

After an uncomfortable night in the hospital I got up and went out to the nurses’ station and to my surprise the doctor was there. Since Caden had a good night I asked him when he was planning to round so he could assess him and hopefully get discharged. He indicated he would see us in a couple minutes. That was about 7:45 a.m. When the nurse came in to give him his steroid medicine I asked her to wait until I had a chance to speak with the doctor. The steroid really winds him up and I wanted to find out more about it before he had another dose. The day wore on and no doctor. I finally asked the nurse when the doctor was coming in and she told me that a different doctor was now taking care of Caden and she would be in shortly. Changing doctors is rarely a good thing because it always takes each one a while to figure Caden out and get comfortable with him.

The doctor showed up just before 1 p.m. and I started off talking to her about discharge. She said she would not be comfortable discharging Caden until after he had been off oxygen for 24 hours and was doing well. I challenged her on this since the other doctor had indicated we could go home as long as Caden had a good night. At this point I really felt like Caden was doing better and keeping him in the hospital did not make sense because of the extra germ exposure and the lack of sleep. I believed the next step in the healing process for him was to get some good sleep, which he was not getting in the hospital. Of course the doctor was worried about possible re-admission. I understand this concern, however at this point we had a treatment plan, Caden was doing well, and the treatments he was getting in the hospital we were already set up for and doing at home. After laying the whole case out to the doctor I got her to agree to discharge us at 9 p.m. as long as he continued to do well.

Shortly after the doctor left Caden went to sleep. While this was a good thing, it was poor timing because my mom, who was in the bay area for her 60th birthday came over to visit with her four sisters, Kyler, and Natalie. We all enjoyed watching Caden as he slept, but it was not too long before his little cat nap was over and he woke up to a room full of guests. Of course since most of these people had never met Caden before it was picture time. With hands washed and cameras ready we began snapping photos. After about an hour and a half the fun was over and it was time for them to head back to the bay to get ready for their birthday dinner celebration. Originally Caden and I were planning to be there, but his little episode prevented that.

The rest of the afternoon was pretty quiet and by about 4 p.m. Caden and I were exhausted. He fell asleep and I pulled out the chair bed and was right behind him. We both slept for about 2 hours. I woke up occasionally with various noises and would always look up to check Caden’s oxygen saturation and vitals. Normally the oxygen saturation will drop off with sleep and so this was going to be a critical test for the doctor in determining whether we would get discharged. His saturation always looked good when I check and later when I talked to the nurse about it she indicated that they never dropped once the whole time we were asleep. She said he looked great and we were ready to go home. It was only 6:30 by this point and I was excited. However, my balloon was quickly deflated when I was reminded that the doctor had strict discharge instructions that said we could not leave prior to 9 p.m. The doctor came in shortly after that and I thought we might get to go early. No such luck, she stuck to her guns and would not let us out a minute early.

Fortunately the nurse who came on night shift was briefed on our status and she worked to get everything ready prior to 9 p.m. so that as soon as it was time we could walk out the door. I got everything packed up and then I went down to the car to get the stroller so I would only have to make one trip out. Caden seemed excited to get in some real clothes and we headed home right at 9 p.m.

Of course coming home was no real picnic because I now had to assume all the care. I started thawing milk right when we got home and then I drew up a bath for dirty little Caden. He was so happy to get in the water and get clean. He really likes his baths. Once he was all scrubbed down I dried him off, got him dressed, gave him a breathing treatment and put him to bed. He went to sleep almost immediately. I kept working getting things cleaned up and put away and finally got to bed myself around midnight.

I set an alarm for 4:45 a.m. which was his first scheduled breathing treatment. That point came all too quickly, but when I got up and observed him he sounded and looked so good I decided not to disturb him. About 6:30 I got up to check on him again and he sounded ready for a treatment. I got him up, changed his diaper and then started the treatment. He stayed awake for about 60 seconds and then he was out. It took me another 20 minutes finish the treatment and put him back in bed, but he never woke up. I went back to bed and amazingly got another couple hours sleep. I rarely am able to sleep in past 7:30 a.m. Caden continued sleeping until 11 a.m. The poor little trooper was tired. The sleep did him well though as he woke up happy and visibly better. Even though I had to push the doctor I believe coming home was the best thing for Caden. He obviously needed his rest.

So that was the end of our adventure. Caden is back to 100% for him. The doctors want us to keep him home throughout the winter to minimize germ exposure. Starting November we will keep him home except for doctor appointments. We are now set up at home with oxygen, pulse-oximeter, portable suction and breathing treatments so we are hoping to keep him out of the hospital even if he does get a virus.