The Plague Take 2 (on Plague #1?)

So the last almost four years, Covid has been front and center in in my brain on the list of things we needed to avoid. I'm grateful he didn't get it until there were vaccines to blunt the response, home tests to identify it rapidly, and medications to mitigate it. Frankly, that sequence probably saved his life. When he got it in September, he was miserable: tired, achy, and sleepy, but he handled it at home.

But this weekend, the one I've been worried about his whole life showed up (again). Almost ten years ago he came down with the flu. He did okay with that one with the help of an awesome ped that called in Tamiflu for him. 

But he's older now; his heart and lungs are sicker. And yep, it's here again.

He kinda battled some kind of respiratory "stuff" the week after we came home from the hospital, but other than increased breathing treatments and a bit more suctioning, he did okay. By mid-week this past week, we were seeing smiles, goofiness, and all around awesome things (although still a few more respiratory treatments). 

Then Saturday...

I was woke by a phone call from my nurse. His heart rate was pretty high. How high? I was thinking maybe 110-120's, probably the result of his albuterol treatment he'd just gotten. Uh, 139. Yeah, a bit higher than I was thinking. I told him I'd be right out and asked if he'd taken his temp. No, he hadn't, and yep, it was high. 40° (104°). Kinda up there...

We started Motrin, piggybacked Tylenol.  His temp went down and up throughout the day. I saw 39.2° but mostly he was 39.5-39.8°, with both meds on board. His oxygen needs fluctuated, but mostly trended upwards. He did have some "stuff" in his nose and trach, but not much; nothing like what we see with rhinovirus (which we haven't seen for a few years and that's just fine!). By early evening, I was putting him on the big tank at 12 and 15 liters, but he was breathing so fast (due to the fever), it was hard to get the FiO2 up very high at all. Usually, when he's breathing normally, eight liters is pretty close to 100% FiO2. Instead, even at 15 liters, he was capping out at about 75%. 

I struggled with taking him in though because he was actually acting pretty okay! I mean, yeah, he was sick. He was tired and less enthusiastic. But he was still playing with toys, listening to Dad read Harry Potter and mostly being himself. It was just those darn fevers. 

And then the oxygen.

Because by the time we were done with dinner, he was maxed out on the oxygen I could provide and still struggling to stay up. We tried bagging him, which worked, but only when squeezing the bag. 

In the end, about 10-ish, I gave up and we called our local heroes. 

And up here? Well, everything looked pretty good. He'd had labs done on Tuesday to make sure he was still in an okay spot after discharging two+ weeks earlier. Those had a couple bumps on them, especially in the white blood count, but the ones up here looked better. We'd moved his spleen ultrasound based on Tuesday's labs and that hadn't changed.

But then his viral panel came back. 

Influenza A

So here we are. 

In the PICU.

But he's nowhere near the sickest kiddo here. He just needs a lot of oxygen. They're giving Tamiflu. And today is day two. The first three days are supposed to be the roughest so I'm hoping that by Tuesday we see improvement. 

Overall, given everything going on, he really does look okay. He squirms down and to the side in his bed. We can't keep him upright. That's a good sign. He is sick and he looks sick, like anyone else with a high fever would look. But I'm hopeful that with Tamiflu on board and the supports he's getting this stay won't be terribly long. 

Fingers crossed... 

"The difference between perseverance and obstinacy is that one comes from a strong will, 

and the other from a strong won't."

Henry Ward Beecher