pNOAHmonia

Case Study:

20 month old male presents

Father pushed to have son seen today. Parents say that the only thing identifiably wrong with him is that he slept until 10am this morning and went back to sleep right after eating breakfast. Mother said, "He seemed fine yesterday, but seems "off" today."

Parents report No fever

No vomiting/diarrhea

Eating/drinking well

Bright Alert Responsive

Coughed 2 or 3 times last week.

Sounds a little bit stuffy, but no nasal discharge and no cough presently.

Child has Trisomy 21 and a repaired AV Canal.

Physical Exam:

Axillary Temp=97.9

ENT all look normal.

Lungs sound clear.

Heart sounds normal

Slight petechia (red spots) on abdomen.

Pulse/O2 Sat = 148bpm and 99% (normal)

Doctor says child could just have a bug which would cause the discomfort and upper respiratory noise and the rash. Parents seem very concerned and anxious though nothing significant is presenting except that child seems "off" to them. Doctor suggests bloodwork and if that looks abnormal to proceed to an xray. Parents agree to bloodwork and mother requests an immediate xray. Doctor asks mother what she hopes to see/find with an xray. She doesn't know as it doesn't appear to be pneumonia, but she still requests an immediate xray.

Bloodwork: Normal

Platelets normal (Petechia can be caused by low platelets and other scary things).

WBC normal indicating no infection.

Radiographs/Xray:

Right sided Perihilar Infiltration (ie crappy fluffy looking lungs on xray...ie pneumonia).

Results:

Doctor says it's possibly viral pneumonia (as opposed to bacterial) but will start on antibiotics regardless. He says that a mother's instincts really do count for something and looks amazed that we caught pneumonia before any concrete signs presented (cough, fever, crackly lungs, etc.)

All I have to say is, "Thank you, God!!" We had NOTHING to go by except a feeling that Noah wasn't doing well and that he slept late. Kind of hard to go to the doctors with nothing to show and to basically ask for bloodwork and radiographs. When we got in the car Chad and I got the breathless shaky feeling when you realize you almost got hit by a car, but didn't. Then you get that nervous hysterical kind of laughter when there is really nothing funny going on. As some of you know, we were in the hospital 2x this past winter for pretty bad pneumonia that cropped up after merely 1 or 2 days of Noah having a simple cold or slight fever. We are so thankful to God for making Chad so in tune to Noah's behavior this morning and that he didn't pass it off as Noah just being overly tired or just coming down with something (which is what I was thinking). Chad urged me to get a doctor's appointment. Also, once I was on board I insisted on a radiograph when all my medical training, Chad and the doctor all said this was an unnecessary diagnostic due to lack of signs. If we hadn't gotten the chest radiograph we wouldn't have found the pneumonia for a couple more days. God let Chad and I be aware that something was wrong when, in any other child, nothing appeared to be wrong. If we had waited 2 days for the fever and bad cough to crop up, I am convinced that we would be facing a week-long hospital stay for pnuemonia....during a week when Chad will be starting work for 12+hrs a day. God also gave us a doctor that was sensitive and responsive to our intuitions and didn't berate us for being hypochondriachs or whatever, and God gave us an actual Radiologist to read the films a few minutes after they were developed...that has never happened for us. We always have to wait days to hear the official report while the Pede waffles with uncertainty.

So, again, we say, "Thank you, God!" instead of "God, why does Noah get so sick? Why do our lives suck so much?" That's a big change for us!

As I've said before, I've been realizing that our lives are probably not going to get easier as far as the health of our children and the ease of raising them. However, Chad and I are learning to see and understand that, instead of removing troubles from our path, God might choose to help us through them. I used to be pretty pissed at this concept, but now I am starting to take comfort in it. I'm not fully sure yet why that comforts me, b/c I still think that if God would remove our struggles things would be so much better. But I have an inkling that He's doing His crazy 'God thing' and trying to draw us closer to Him. Even that opens a whole new can of worms about suffering and God's plan, but I won't let myself go there. Right now, I am comforted and it's been a long time since I've felt that way.

Noah has pneumonia.

We caught it before anyone would ever detect it as pneumonia.

We are not (and hopefully won't be) in the hospital.

We have affected the things we could change and are not mourning the loss of the thing (pneumonia) we can't change.

That's huge for us! We are very thankful!!