More Grey Hairs

We had another exciting week with more medical adventures.  Vivian (and I!) had our first ambulance ride.  Not something I would necessarily recommend.  I got a cell phone call at work mid-morning from her caregiver, saying, "please come now!"  She is Spanish speaking and speaks wonderful English, but she was rapidly losing it because she was panicked.  I managed to pick up, "she eat almond, no good, no good, I give her the medicine you give me," and something about her breathing.  I only had two kids in my classroom and grabbed the Epi Pen I had in my purse and ran out the school and across the street.  She met me on the street, white as a sheet, with Vivian who was still breathing irregularly, kind of a wheezing, gasping sound.  Apparently she had one almond and started having difficulty breathing so her caregiver administered her Epi Pen.  The one we had for dairy, that we never thought we'd need.
I grabbed Vivian and ran back up to school where my car was, calling the pediatrician's office on the way, who told me to "call 911 immediately."  I didn't know whether to take her in my car to the hospital or not, so I figured the safest option was to take her into the school nurse.
The nurse immediately looked at her and called 911 (like I was supposed to do).  In a public school setting, this sets a number of events into action, including putting the school on "shelter in place," which means children cannot be in the hall (transition anywhere) and everyone must stay in classrooms, as well as sending the crisis team into action.  It took the firefighters about 6 minutes to get there and the ambulance about 8 minutes, which is a little scary.  Meanwhile a coworker grabbed my purse from upstairs.
The firefighters who arrived first got the carseat out of my car, for the ride home from the hospital, while others tended to her, she was in my arms wisely refusing to be put down.  Vivian was not a big fan of the oxygen mask they tried to put on her face and started to scream hysterically, which actually made me feel better because she had enough breath to scream and that is typical behavior from her.
When the ambulance finally arrived, I carried her outside and they raised the stretcher to a seated position and tried to strap her in.  She escaped from the shoulder belts  and would not stay on the stretcher.  Since law says she has to be restrained when transporting, it meant they had to install the carseat to transport her.  Which I understand, but seems counterintuitive if you really are racing against time.  It took three of us to get her into the carseat and strapped in, during which she was obviously hysterical the whole time.  They got a toe monitor on her which pissed her off even more and she screamed bloody murder.  Finally the ambulance started moving and she quieted down.  By the time we reached the Mass Pike she was pretty content to look out the window and wave to the second ambulance behind us.   I'm still not entirely sure why there was a second ambulance…
Then she promptly passed out, pulling her "this sucks, I'm going to sleep to ignore it entirely" trick, but the EMTs kept trying to "revive her" though all of her numbers on the monitor were actually fine at that point, except her elevated heart rate.   We arrived at the hospital with an escort of five medics and another gentlemen met us.  It was quite a scene.  Vivian was now awake and chatting away in her carseat on the stretcher as they wheeled her through the adult emergency room and into pediatrics.  Her good humor ended the moment we reached her little area to be treated in.
Suddenly the room swarmed with people, two nurses, a life nurse (or some title like that), the registrant, and the medics who were slowly clearing out.  They took Vivian out of her carseat and she looked around and yelled.  Nurse Nancy was apparently in charge and Vivian and Nurse Nancy immediately went head-to-head.  Nurse Nancy was a tall blond, perfectly put together, and made scrubs look like a power suit.  She was a stickler for procedure and protocol and Vivian wanted nothing to do with hospital rules.  Nurse Nancy began to demand Vivian's weight and had the other nurse bring in a baby scale.
"I don't think she's going to sit on that," I told Nancy.
"She has to.  I need her weight," Nancy told me.  Meanwhile, I was trying to finish paperwork with the EMTs for the ambulance, the life nurse was blowing bubbles to calm Vivian down, another EMT was blowing up a rubber glove to distract her, and Vivian was glued to me like a barnacle.  I peeled her off and put her on the scale.
"Stay still!" Nurse Nancy barked.  Vivian was a horrible shade of reddish-purple now from the reaction and she was not staying on that scale.  She tried to scramble off the scale.  I caught her.
"I need her weight!" Nancy told me.
"She's 24 pounds," I told her.
"Her exact weight.  I have to have it." she said.  She yelled at the male nurse to get the adult scale.
"I'm going to get her weight," she informed me.
The life nurse was now reading "Goodnight Moon" loudly while the EMTs started to clear out.  The male nurse heaved a large adult scale in.
"Get on mom," Nurse Nancy ordered.
I got on.
"Now get off.  Give someone the baby."  I handed her screaming to the male nurse and I got back on the scale.
Nancy smiled with satisfaction.  One point for Nancy.  Now there were only four of us, plus screaming Viv.
Nurse Nancy managed to get the sticker monitor on Vivian's toe which royally pissed her off even more.  Then she had to listen to her chest.
"I can't do this!  I'm getting someone else."  She stalked out and came back with a  very good natured, pleasant doctor.  He placed the stethoscope on Vivian's back and listened to hear, though how he heard her over her wails, and the life nurse banging on a plastic piano, I'm not sure.
Finally Vivian went to sleep on my chest while they poked her and watched the monitor.  The pleasant doctor was pleasant, I explained the life nurse that just some quiet and calm would be good- no, not bubbles, and they retreated.  The registering guy returned and registered us and printed out a bracelet for her.  He looked at me, "she won't want to wear this will she?"
"No," I said, "probably not.  Does she have to?"
"Well, yes," he said, "but it's not worth waking her up for and you're with her.  Maybe try later."
On his way out, Nancy glared at him from her seat at the desk, "I'm registering them now," she told him, "they're not in the system yet!"
They had a quiet exchange and he went on his way.
She came in and looked at Vivian, "is she wearing her bracelet?" she said eyeing the bracelet lying on the table.
"No."
"Well it's hospital protocol!!!" she told me.
"I can wear it," I told her.
"The patient has to wear it!  If she leaves this room she has to have it on!"
We looked at Vivian who was sound asleep.  "She's leaving?" I inquired.
"If she gets an x-ray she has to have it on!"
"Is she getting an X-ray?" I asked.
Nurse Nancy sputtered, "No.  But if she leaves this room it's hospital protocol!"
"Okay, I'll put it on her when she wakes up or if she leaves the room."
She glared at me.
"We'll be back to examine her," she told me.

They came back a few minutes later, luckily nice doctor was in charge.  He listened to her again and said her airways sounded good and then had to look in her throat to see if it was swollen.  He explained that what was done from here was to give her Benadryl and Dexamethasone, a steroid to open her airways and keep them open once the epinephrine had worn off.
"She can take it all orally," he told me and off he went.
I was left with Nurse Nancy.
"So, Vivian doesn't like to take medicine orally," I told her.
"What do you mean?" she demanded.
"I mean we hold her down and she spits it out, moves her head, we get very little in.  The best luck we've had is giving it to her in suppository form."
At this point Vivian was crying again, because she'd woken up to find herself being examined and while she was awake, realized her foot monitor was still on.
I swear Nurse Nancy was about to roll her eyes.  "Is this your first?" she asked me.
"No.  It's not." I told her.
"Well, we can inject her with them.  Is that what you want?"
No it was not what I wanted, but it would be easier and less dramatic for all of us.
"Yes, let's do that."
"So you'd rather she had three shots then take them orally?"
Okay, was she now making me out to be a horrible mom?  Had she ever held this child down repeatedly only to be covered in medicine and have her actually take none?
"I think that's the best thing.  Wait, three shots?"
She ignored me.  "Wouldn't you like to try one orally at least?"
"Fine, let's try one orally."  Let's prove to you that she won't swallow it.
She glared at the hospital bracelet (which I was under no circumstances now putting on my daughter) and left.

She returned with one syringe for the oral medication and the syringe to inject her with.  Of course Vivian had just gone back to sleep.  We woke her up and as she was just coming to, I (apparently this was now my responsibility), stuck the syringe in her mouth and got the majority of the medicine in before she flipped out, gagging, and spitting it back at me.
"Well, she is a firecracker." Nancy told me.  "I've really never seen anything like it."
Yes, I'm sure unruly, pissed off toddlers never cross your path in this line of work.  My god. Really?
Another nurse approached with the syringe and the three of us held her down and they administered it.  Naturally this set off another round of screaming, now she'd had the Epi Pen in one leg and the steroid in the other.  Poor kid.

From here it was mostly just Vivian falling asleep on and off, occasionally being prodded and monitored.  Nurse Nancy insisted on turning on the lights every time she entered while muttering about Vivian's temper.  I called my family, touched base with Chris a few times, and happily snuggled Viv.  Tessa brought me a sandwich and hung out for a while as she works down the street from the hospital.  Vivian looked good all things considered.  Her heart rate was normal, it had been like 280 in the ambulance after the Epi Pen, now it was back in the 90s.  Tessa kept me company for a while and then went back to work.

They monitored Vivian for four hours and then we were discharged.   The problem with the discharge is that coming in, I had had five extra pairs of hands for the carseat and my purse and bag.  Now it was me, a carseat that weights like 50 pounds, a 24 lb (yes, I was right) toddler I had to carry, and my bags.  Vivian was barefoot as in the chaos of the morning her shoes were left at her baby-sitter's.  And naturally, during this whole adventure I was wearing a black maxi skirt that would slide down and make it impossible to walk (let alone climb on and off of stretchers, run in, and climb in and out of ambulances in).  So now I was struggling through the hospital out to the main entrance where my mom was picking us up.  Nurse Nancy smiled at me, "good-bye now!"
I gritted my teeth and managed a smile, "bye."

Roz and Vivian and I retrieved my car from work and were home before dinner.  I even managed to get a call into her pediatrician and book an allergist appointment before the offices closed. Sam played with Nana and I took Vivian outside to play for a little while.

Through everything I was calm and felt like I had my head on.  I don't know how I would have reacted if I had seen her truly laboring to breath or god forbid, worse than she was.  I was exhausted at the end and the next day too, but I felt okay with everything.  I think I came to terms with her having a food allergy when we were testing her for dairy allergies.  It wasn't until Saturday when I went to Whole Foods with her to pick up some groceries that I found myself crying.  We were in the rice aisle and Vivian was pushing the cart around while I quickly grabbed things.  I inadvertently took a Toasted Almond Rice Pilaf off the shelf in my haste.  When I realized what I was holding, I discovered I was crying, in the middle of the grocery store.  We must have been quite a sight, Vivian wildly pushing the cart into shelves while I cried over a box of rice  mix.  I just realized how easily she could have a nut and how close we had come.  We have a series of steps to go through now, but all in all, we are really lucky.

Chris and Sam went away for a few days, so I have had some quiet time with Vivian, which perhaps we both needed.  She came down with a fever on Friday night, which I cannot separate from everything that happened on Thursday, partly, because I don't want her to have a severe food allergy, I know.  But it all seems so coincidental, though she really probably just picked up a virus at the ER.  She is clingy and tearful, whether from having a virus or being traumatized, it's unclear.  I'm just enjoying her holding onto me and taking it for what it is, but I hope she is herself soon.  Sam and Chris will be back soon and I think that will make her feel better too.

 precious girl