Avi’s Hospital Sleepover

Avi goes to Mothers Morning Out a couple times a week, and has 3 times now had an ‘episode’. They put him in the swing when he gets cranky and he falls asleep in there. While sleeping he will go pale; lose all his color and his lips even look pasty. Anne, his caregiver, rubbed him on the chest to make sure he was breathing. He then puked a bit, took a big deep breath, and his color returned. All while sleeping. Another time he vomited up clear bile-ish stuff. They called me to come get him the time this happened and I was able to see the symptoms…he basically looks dead. That time I picked him up and nursed him and he was back to normal so I just thought he had been crying too much and made himself sick. Well, when it happened a third time it seemed extra bad and very scary so the MMO director called me and suggested I get an appointment. It was much more than him being fussy since he had happily gone to sleep this time. That was Friday morning.

I called the Moody clinic to get a suggestion. Avi has his one year checkup on Wednesday, so I thought I’d just wait til then. the clinic was closed, so the on-call pediatrician got on the line. She listened to the symptoms and recommended I take him in. Now, this lady is the Lt. Col that notoriously (amongst the wives) is a bit off her rocker and doesn’t always take us seriously. She’s a big “wait and see” kind of gal. So, when she told me to take him to the Hospital Youth Urgent Care center I knew the symptoms could be big. She also said that it could be nothing, but better the doc’s at the hospital laugh at me than ignore serious stuff. Her thought was that they would be doing a bunch of tests and if I waited for my clinic appointment, I would simply find myself down at the hospital anyway to get testing done.

I took him into South Georgia Medical Center Youth Care first thing Saturday morning expecting to hear I was nuts and to just go home. Well, when we finally saw the pediatrician two hours after arriving she was a bit mystified by my happy bouncy baby boy. She also took me seriously, thought it needed more investigation and admitted him to the hospital. Her thoughts were that it could be: reflux, sleep apnea, or seizure. In my naivete I thought we may be there for the better part of the day for tests and then get discharged. Not so.

Avi, Zoe and I were wheeled up to room 208 in pediatrics and settled in to watching some TV and playing with the cool bed/crib. Avi got hungry, but I was told he must not eat until after xray so he got quite angry and pitched a huge fit. I think he really wanted to nurse, too. I ended up just letting him cry in the crib as there was no consoling him. Since he was mad the nurses found this the ideal time to take blood for some baseline tests. I hate this stuff. The nurse was great though! She stuck him first try and he was fine. He eventually fell asleep and soon after we were wheeled down to xrays in a giant wheelchair that sat us side by side. Zoe thought the whole thing was quite fun and interesting; she was very good the whole time. I was impressed with her. Avi was now royally pissed off to be awoken and held against his will for xrays. Then, after starving him of good mommy milk or any food for the last 2 hours I force fed him some barium in a bottle. This was for the upper GI exam – a radiologist came in and watched the barium go down his body while we (again) held him down on the table – it took 3 of us to keep him still. All this was to look for reflux problems. He happily nursed when it was all over and ate some fish crackers.

When we got back to the room I asked the nurse what else was on the agenda and how long it would be. She goes, “oh you’ll stay overnight”. That would’ve been nice to know a while ago. I frantically called my friend who was so nice to come take Zoe. She also grabbed some Avi toys out of my car and got me lunch! so nice to eat since it was 5pm by that time. Now Zuzz had been great and wanted to stay, but I just knew there would be no sleep that night and she really needs hers. Plus, as fun as the TV was for an hour I knew another 24 hours would get dull. She reluctantly left – they stopped by our house to get her overnight stuff and Zoe was off to her own first sleepover!

Back in the room Avi had his snacks and promptly fell asleep nursing. I put the crib rails up, notified the nurse, and ran to my car. In 25 minutes I drove home, grabbed myself some junk for overnight, drove back, and hastily made my way to the room. I didn’t want him waking and feeling abandoned. He was still asleep! and then he slept for another 2 hours! Around 7:30 he finally roused to find his cold hospital dinner waiting him. He chowed down on roast beef, overcooked green beans, and mashed potatoes. We then got around to some exercise. Avi ran up and down the ward hallway for an hour. It was hysterical and he had a blast in his tiny hospital gown. We visited the other kids, pointed at the cool wall paintings, and had fun peek-a-boo-ing in the doorway. He even got a balloon from another little girl – she was just under a year and they walked holding hands for a bit. He’s such a happy guy; this is the point when I was like, “why are we here?”

That passed when they started talking sleep test…once he fell asleep for the night around 10pm the nurse came in and hooked him up to a monitor. There were 3 wires on his chest and one on his foot. It measured heart rate, breathing, and oxygen levels. The first time the alarm went off I about freaked out. She said it may occasionally beep a single time if he rolls and the wire pinches briefly. BUT, this was a real alarm – on the monitor his breathing was a flat little line! aaahh. the nurse came and assured me he was fine. She showed me where the numbers were and noted that his breathing was just very shallow – under the ‘norm’ which is why it alarmed. he WAS actually breathing. Of course I could have looked at him and seen that. Around midnight I was able to give Bryan an update on Skype.  It was good to talk to him and he was relieved to know it wasn’t something immediately serious.  Throughout the night the alarm went off about 8 times for shallow breathing…the nurses would come check him and we was always fine. Never did he go pale and pasty like at MMO. Needless to say I didn’t get much sleep on my fold out chair. He wasn’t allowed any food after 4am, so when it alarmed at 3am I was actually glad so I could nurse him one last time. He woke around 6am ready for some food or nursing and was, again, fairly pissed off I wasn’t giving him anything. We snuggled up on my chair, though, and fell back asleep til 8am.

The final test of the visit was an EEG to measure his brain waves. For this he must be still for 45 minutes – so they had to sedate him which is why he had to starve. The nurse brought in some medicine at 9am that made him loopy. He was too funny trying to grab her nose, trying to stand without balance, and thinking his books were just incredible. After about a half hour of loony time he fussed a tiny bit and fell asleep. The EEG lady then arrived and glued 20 or so wires to his head in a very particular manner. We then all had to be quiet while the computer analyzed. At one point she got out a strobe light and flashed that above his sleeping face. Then, all of a sudden, the room phone rang. I picked up and hung up right away…and it rang again…the nurse answered. It was the kitchen asking what to get Avi for lunch! aarrghh.. Well it woke him up. The EEG technician said it was OK, it only lost the last 30 seconds or so of the 20 minute test. She quickly got him unhooked before he freaked out about all the wires. Then my happy little boy got some lunch!

Late in the morning the doctor came in to review. The x-rays and upper GI didn’t show any reflux, but she wasn’t convinced it wasn’t happening sometimes. Especially since he’s a puker. She prescribed Prevacid for a trial month. The overnight sleep monitor showed he never actually dropped a breath, like apnea, but he certainly comes close and breathes very shallow. So, she ordered an at-home apnea monitor for us to use for a month to really evaluate it. Maybe that is his normal pattern, or maybe it’s apnea. We’ll see. He doesn’t behave like someone with apnea though – he isn’t tired throughout the day. He isn’t a great sleeper (still waking once most nights), but it does seem that he is well rested. The EEG was to test for seizures. The neurologist will look at it on Tuesday, so that is up in the air. The doc thought this was the least likely reason, but just wanted to check in case. So, obviously, Avi won’t be sleeping in the the swing anymore. We’ll see if he has any episodes out of the swing. The doc really seemed to think it had to do with reflux or gastro-something. Her theory is he vomits or reflux-es in his sleep at home while sleeping, but since he’s on his belly or side it just comes out. He does wake up most mornings very moist. I always took it for drool, but it could be some puke puke. At school, however, …as the theory goes…when this happens in the swing it chokes him, he can’t breath and goes pale, then his body reacts with a violent puke and all is well. Natural reaction – just drastic and a bit odd. She is quite intrigued and I can tell she would like to follow up. Hopefully the Moody clinic will continue my referral with her until we figure it out. They likely will.  We were discharged in the afternoon.  Picked up Zoe and promptly went home to nap.

In the late afternoon we still kept up a bit of our social agenda by going to the squadron wives’ Labor Day pool party.  We had a blast.  Back to normal!

Anyway, he seems fine to me. I’m glad we went in to rule out some serious problems and get on track to figure out what it is. I’m not concerned about him sleeping and having an episode at home. I don’t watch him sleep, but I have never seen him look pale at home as if he had an episode…it’s not like the color comes back instantly. He is a healthy little boy…no more sleeping in a swing.

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