Confused

So.....Ethan decided to visit the big house again.  It all started Saturday afternoon when I made the mistake of checking his O2 sat with our little portable monitor because he was kind of fussy and agitated and while holding him noticed he was panting to breathe and could feel some rattling in his chest. It read 67. Not good. But I wasn't sure I believed it. But before we traipsed on over to Children's Urgent Care, after the ordeal I got for taking him there last time-and not really wanting to drive downtown to find ours was inaccurate and he was really 97, I thought I would verify with a real monitor. Called my sis, and being that we just happen to know some people who know people, we had front door service with a real monitor in about 15 minutes. 

Long story short-our sat monitor was inaccurate. He was actually 73. He lives at 98. 

By this time he was no longer panting, in no respiratory distress, not retracting, just had oxygen sats in the crapper. Looked perfectly fine. But he was wheezing a bit. So we figured his asthma had been exacerbated by the change in weather and allergies. I figured some deep suctioning, Atrovent and the miracle car ride would find us going right back home in a couple of hours. So we took him to Urgent Care North. Sats in the 70's there bought him a chest X-ray, blood work, a couple of breathing treatments and some steroids, and after all that, when his sats wouldn't come back up, an admission downtown.  The Dr there has taken care of Ethan in the past, and really felt he sounded and looked like an asthmatic episode. But his white count was elevated and his liver function labs were elevated.  The Dr wasn't overly concerned with us bringing  him there. The Respiratory Therapist however, was, for lack of using nicer words, a prick about it. He berated me for not calling an ambulance  and having him run hot downtown. He continued to say that sats in the 70's always require an admission.  And how I should have known better than to bring him to UC-what if they had to provide him with more support than they were already doing?  Oh, what, actually do some work?  Cause as soon as his breathing treatment was done, we didn't see him back in the room until it was time for another. As a matter of fact, after he helped us take Ethan over to X-ray, while I was helping get his chest film, he said he would be right back to help us take him back to his room, and stepped out. Guess who never showed back up?  And as the tech and I managed to get him back on our own, he was sitting at the desk chatting it up. 

 If Ethan were so critical he couldn't be managed there, I'm guessing I wouldn't have been the only one in the room with him except when labs or breathing treatments were being done. I know what critical looks like. I've seen it with Ethan. My son was a DNR at one point. And like I told the admitting docs who asked what his normal baseline was and I pointed at him and said 'just like this-minus the low sats'. Ethan looked no different than he did when we put him on the bus for school Friday. My crazy mother instinct told me something was off, and I was right. 

Strike 2 for Children's Urgent Care North. 

They don't get a chance for #3. It will be downtown from here on out. People who don't want to take care of my son don't get to. We will let you use your mad skills on runny noses and ear infections since he's too complex for you. 

Up to 6 Henson we went-but not before seeing all Mom's old co-workers in the ER who couldn't believe how big the bald kid had gotten and couldn't resist a few hugs and rubs on his handsome smooth head.  

Last night he did ok, slept with 2 liters of oxygen on, and when they tried to wean him he dropped to 78-even while awake. We have not yet seen any low heart rate episodes this time-knock on wood. 

They did do a virus panel and it was positive for rhinovirus and enterovirus. So he has a cold. And a virus everyone else tolerates like a cold. But he's got sats in the 70-80's. 

Today the team rounded and decided to just completely shut his oxygen off and as long as he remained above 80 he could go home this afternoon.  80?!?!?  He lives at 98-99. He had to be admitted for 70's and last admission-5 weeks ago-he couldn't go home until his sats were above 96 on room air. 5 weeks later 80's are acceptable??? What changed???? Oh, I forgot, we saw Cardiology on Wednesday and his valve leakage is now severe, and a valve replacement is probably 12-18 months away. However since we know Ethan doesn't tolerate pulmonary insufficiency very well, it could be sooner.  And as Dr Kaine said-Ethan doesn't do anything typical, so who really knows. But we are going to do follow-ups every 2 months. So I guess since we know his valve is crappy again we should just expect sats in the 80's and accept them.  

The resident said the cardiologist on today was not at all concerned about any of this being his heart after having reviewed his last echo, EKG and Dr Kaine's notes.  

But after I mentioned he's not on oxygen at home, he lives at 98-99 and the reason he had to stay so long last time was because he had to be back at baseline why is 80 now ok??  

No good answer, but oddly enough his orders got changed to "has to be at 90 or above or back on oxygen". And he's been on oxygen again since 1pm. 

Oh, and we just got transferred to 4 Sutherland.  

The heart floor. 

Hmmmmmm.......

Oh, and check out his feet. Puffy much??   

And then the nurse noticed his oxygen tubing was leaving a mark on his face, but it hadn't been tightened.  Retaining fluid maybe?  Nah, it's not his heart. No way.