February 20th saw family doctor when he was struggling to breathe again, prescribed prednisone – completed February 23.
February 24th admitted to ACH with fever and indrawing when inhaling, needed to be on oxygen (oxygen saturation 69-72% on room air), xray was much better than Feb 15 but still lots of ‘fluff’. Tested positive for Influenza A. Supported with Ventolin and Saline Nebulizer and frequent suctioning. Although not recovered, after a week it was felt Braxton could be supported as well at home as in hospital, and went home with a nebulizer and prescription for Ventolin nebs every 4 hours as needed for a month, and oxygen 1LPM 24/7. Follow up with respiratory march 30. Discharged March 1.
We were advised that Braxton will take a long time to recover from the back to back respiratory virus infections, probably at least a month for the pneumonia, during which time his immunity would be compromised.
Braxton now requires:
-oxygen 1LPM nasal prongs at all times
-Positioning to allow drainage, sitting up leaning forward- especially when coughing. Sleeping on side with head elevated. Turning him from one side to other throughout night to make sure the infection does not get a chance to stick to one lobes of lungs.
-frequent suctioning. He is coughing up the mucous from his lungs and is at high risk of aspiration if not assisted. Suctioning in nose and cheeks of mouth, trying to avoid gagging to reduce chance of vomiting.
-Ventolin nebulizer as needed when breathing becomes difficult up to every 4 hours
-chest percussion to loosen mucous (not during feeds). Saline neb can also be used to loosen mucous but can lead to coughing fits, so Ventolin should be given after saline nebulizer
-tylenol/advil to control fever and throat pain
-comfort during coughing fits. A cool damp cloth to forehead or back of neck helps. Warm bath in steamy bathroom. Lots of cuddles and back rubs.
-frequent change of bedding/clothes that have been drooled, spat up, or sneezed on
-extra water in between feeds if tolerated