croup

20 Dec

Once you hear the seal-like barking cough of croup, you never forget it.  As a sub-I on the wards last February, I heard my share.  It sounds terrifying, like the entire airway is obstructed.  But then you look at the patient’s oxygen saturation, and it’s close to 100% most of the time–bizarre!

I was really surprised when, hours after Ari went to bed, John listened intently from downstairs, and concluded that she might have croup.  I had heard her cough maybe a few times during the day, but I brushed it off as par for the course given that it’s nearly winter and both kids have been massive producers of snot for the last month or so.  As I listened from the stairway, I heard a tightness as she tried to clear her throat.  Oh, we were in for it.  26 months of skating away from most childhood illnesses, we were more than due.

Things got worse the next day in that Ari’s cough picked up intensity and frequency.  She was more fussy, but I couldn’t appreciate any more concerning signs, like an inspiratory stridor (a high-pitched breath sound from turbulent air flow in the larynx) at rest, increased work of breathing, increased breath frequency…and she just didn’t look sick.  But kids tend to benefit from a single dose of corticosteroids (oral or IV) regardless of severity, so we thought we better get on it.

At our local pharmacy, the pharmacist handed me a medium-sized bottle of what looked like cough syrup and I thought to myself, Great.  What am I going to do with the left over medication since she only needs one dose?  And then I looked at the instructions: Take 80 mL once by mouth.

Seriously?  Uh, that’s nearly 3 ounces…like, about the amount of any fluid Ari might consume (when she’s really thirsty) over the course of dinner.  I looked at the pharmacist, who cringed and nodded sympathetically, then added, “I’ve been told that dexamethasone is one of the better tasting oral steroids.”  UpToDate, on the other hand, states, “The oral preparation of dexamethasone has a foul taste,” to which my eldest and I can now personally attest.

Oh, it was awful!  John and I (mostly John) gave Ari two 5 mL syringes of the syrup at a time, with five or so minutes in between for an Elmo (“Elmo Calls” iPhone app = sanity saver) or “special snack” break.  After about 30 mL, Ari was begging, “ALL DONE! ALL DONE!”  After 40, she was shoving her blankie so far into her mouth so as to try to block any possible point of entry.

Two minutes after the last cc, Ari looked like this:

IMG_7369 IMG_7370

Singing along to this video:

So hopefully no lasting trauma.  And “forts” and “boats” (they don’t have to be fancy, see below) go a long way for mood improvement.

IMG_7366

I wish I could say things were all sunshine and rainbows since then.  After a decent night’s sleep, we had a very mercurial Thursday, which included a trek 3.5 hours away with dependents sans husband for a residency interview.  My best friend generously offered to babysit the kids during my efforts to gain employment, so we stayed with him overnight with the hope being that I could just dip out while Ari and Evie were still sleeping.

After nursing Evie down, I proceeded to rock my clinging eldest for well over an hour before she finally submitted.  Ari was just sick enough to be uncomfortable but not so sick that she actually wanted to sleep…ever.  But after she was truly, truly, asleep, tucked in on her cot with her various animals and books, with pillows surrounding her fort/cot, I really thought the worst was over.  I ate dinner.  I prepared for my interview.  I went to bed.

And then I woke up to her screaming one hour later.  This cycle continued throughout the night.  During a brief moment of peace, I got a shower in and pretended that I was already a resident, sleep deprived from a particularly grueling call schedule, then put my suit on just in time for Evie to squawk and consequently wake her sister.

Parents of my future patients, believe me when I say that I empathize…and this is only plain, generic, run-of-the-mill croup!  I can’t imagine the state I’d be in if my kids ever needed a hospital admission.

This is me pulling it together for my interview (new glasses, I can see!  Thank you, hubs!  They might look bigger in selfies…):

IMG_7387 IMG_7388

I met the other applicants in the hospital lobby.  Nice people…one hesitantly approached me, pointing to my right shoulder, “I think you might have snot or spit-up (or maybe both?) on your suit.”  Luckily, the Medela Quick Clean Breast Pump Wipes stashed in my pumping tote get out just about anything.

The day was lovely, and we reunited with John late last night.  Now we’re looking forward to settling into the holiday (oh, I almost wrote “hospital”) spirit.

 

 

 

Advertisements

6 Responses to “croup”

  1. harveylisam December 20, 2014 at 5:45 pm #

    Hahah poor thing!! Glad she’s feeling better 🙂

  2. hn December 21, 2014 at 1:41 pm #

    Next time ask for dexamethasone in pill form, and crush it up in a teaspoon of chocolate syrup. Our eldest has an unusually narrow windpipe and so gets croup badly enough to warrant steroids/ER visits 3-4 times per year– this advice about the pil in chocolate syrupl v. liquid came from an ER nurse and has saved us many times.

    • annaojesus December 21, 2014 at 11:59 pm #

      That’s a great idea–thank you 🙂 Hopefully next time will be a long way from now! Ugh, sorry to hear that your eldest gets croup so frequently–that sounds awful! Hopefully this winter will be better. Thank you again!

      • hn December 24, 2014 at 7:32 pm #

        No problem! That advice was SUCH a lifesaver for us that I am happy to pass it on! (Though of course, I hope you never actually have to do this and remain croup-free from here on out!)

Trackbacks/Pingbacks

  1. first (solo) flight | anna in med school - January 5, 2015

    […] after the recent somewhat disastrous trip, John figured he owed me.  Today I kissed my girls and John goodbye for the next […]

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

w

Connecting to %s

%d bloggers like this: