Thursday, August 15, 2013

5 months

As of August 3, John is 5 months old. That's awfully close to half-a-year for this mama. We are enjoying this stage, not quite mobile but definitely interacting with us, giggling, smiling, starting to make his needs known.

He does say "mama" when he's mad and lots of gooos and ssisssisss that the girls think means sister and girl. As of today, August 13, he is sitting up on his own...for a few seconds. We still have a set of hands ready to catch him when he weeble-wobbles over.

He loves to stand and hold onto hands. Thankfully, there are plenty of hands around here that like him to hold onto them.

He started daycare on Monday with no problem. I got a little weepy when I left but tried to suck it up. It is hard going to work all night without him and knowing he needs to be at daycare before I leave and after I get home so I can sleep a little. But it's only a few days each week.

He has recovered from the pertussis with no major problems. He does still have a cough, especially when he cries, but they said that could take months or years to end.

Otherwise, he is a healthy, happy little boy!

Monday, August 5, 2013

Whooping cough

My Facebook friends already know this, but I feel like posting some details here and not there.

Officially, Maggie and John were diagnosed with pertussis about two weeks ago. Maggie's been struggling with her asthma, or so we thought, since July 5. She has been in "the red zone" and unable to get her lung function back to her normal 80 percent. Her asthma specialist said, in hindsight, he considered whooping cough as her problem back on July 12, but it was such a long shot, he didn't mention it. In the same regard, our pediatrician saw John on July 18 and thought it was bronchiolitis. The following Wednesday we went in again for the girls' physicals and doc thought it sounded like whooping cough, but it was such a long shot and, per our insurance, two days too early to test for it.

That Wednesday night sucked. I'd rank it the fourth worst day we've had. (The other three are the day our nephew died, the day we almost lost Lainie, and the car wreck that almost cost us Maggie before she was born.) Maybe it wasn't as bad as I thought; maybe the three hours of sleep for the day contributed; maybe the two hours of sleep that night made it worse. But we were afraid to leave John out of our sight for fear he'd stop breathing. Seriously, hell.

The following morning, Maggie had a scheduled follow-up with her asthma specialist again. Just for a long shot, I mentioned it to the admitting nurse that she may have been exposed to whooping cough, but it's undiagnosed. And, I brought the iPad with the video of John from the night before. (Jay and the girls stayed in the car; no matter what he had, we knew John shouldn't be in a clinic full of asthmatics.)
That video convinced her doctor in about 5 seconds, and he and our pediatrician worked together to help us get them both tested and get John admitted. I just couldn't handle another night like Wednesday night, without more backup and at least an oxygen saturation measurement.

For the record, we are all up to date on our vaccines. We aren't sure exactly where this came from, but one hypothesis is that it came home with Katie from camp. Her counselor had been sick while she was there, and Katie came back with a raging cough in late June. Our pediatrician had given her zithromax, which is also what you get for whooping cough, and she was better in just a couple days. So, that's our theory.

Thankfully, John and Maggie responded just as quickly to the zithromax treatment. We were under house arrest for five days, until they were no longer contagious. In just two days, they were eons better.

Also, for the record, I did keep working during those weeks before and after their diagnosis. My first call when we suspected it was to my employer, who called KDHE to verify what she already knew: I could not pass the illness onto my patients unless I was sick myself. I was not sneezing or coughing at all. Still, I would shower right before coming to work, not put on my scrubs 'til I got there, and wipe down with antibacterial lotions before seeing any patients. Even my watch got a wipe-down with alcohol before work each shift. And I was just as germaphobic when I got home, in hopes of not making things worse for J and M.

So, here we are, two weeks later and all better. Maggie is truly back to her spunky self and her peak flow meter shows her in the green zone. Her level of activity shows it, too. At her worst, Maggie couldn't talk through a sentence without catching her breath and she had to lay down mid-meal to make it through supper. Now, she is all over the place, running, swimming, dancing, high-kicking her sister in the nose. Oh, that's another story in and of itself.

John still has an occasional coughing fit but it only lasts a few seconds, not the 30-45 seconds he was doing. He has maybe 6 a day instead of 6 an hour. He has wet diapers again, is smiling again, and is on the move again. It sounds like John will get this cough back for months or up to 3 years, every time he gets an illness. With Katie's and Maggie's and Lainie's health history, being gun-shy about normal childhood illnesses won't be anything new to us. We are still keeping him in more than usual, which means he missed the Abilene fair last Saturday and will not go to the waterpark tomorrow. I'll be a little tighter on my grip on him when we are in public, so we can maybe avoid a second illness anytime soon. But he is better.

And so we exhale. And pray. In fact, we went on vacation this weekend to Nebraska, something we had scheduled months ago. We kept John away from other people's hands, not for their sake, but for his. And we stopped at the Shrine of the Holy Family to say thanks.

We were all over the county fair here in Clay, not knowing that the kids had pertussis. The incubation period for pertussis is 2 weeks, so we are just about to find out if we passed it on to anyone else. I'm praying not.

I learned the Tdap vaccine is not as effective as the Dtap or DTP vaccines were. I learned that the U.S. has gone from less than 5000 cases of pertussis in 1990 to more than 45,000 cases in 2012. I learned the pertussis component of the Tdap is about 60% effective at preventing the disease, although those who are fully vaccinated tend to have a less serious case of it. I learned that you need at least three shots before you have any immunity to it. I learned that my brother actually acquired pertussis from his vaccine in 1981; I had thought he had an anaphylactic type reaction. (needless to say, this whole deal has probably been hell on earth for my mom, too.) I learned that they weakened the pertussis component in the Tdap and Dtap vaccines in hopes to prevent reactions just like my brothers' reaction, which resulted in permanent brain damage. Irony sucks some times.

I also learned that pertussis is a terrible illness to watch, that cough suppressants will do no good, that infants and the very old are most at risk. I learned that infants can have seizures, brain bleeds, hernias, fractured ribs or die from pertussis.

I will continue to vaccinate my kids against this illness, even if it is only 60% effective. Because if I can cut the chance in half that they will have to go through it ever again, it is still worth it. But right now, I just keep praying that we don't catch any tertiary illness (John already has an ear infection) and that we did not pass it onto anyone else.