Dr. Mom on duty

Sam had a great day.  He has been on antibiotics for nearly 3 weeks now (yes again) for a sinus infection.  I don't like having him on antibiotics so often but I don't like spending countless days in the pediatric ICU more.  Sam has shown us time and time again that he will be fine one minute and in life threatening respiratory distress the next with little to no warning.  So even the slightest symptom is cause for alarm until we rule out any major problems.  When Sam has a sinus infection he doesn't even act sick during the day but at night when he goes to sleep he stops breathing.  He does not gasp or wheeze or fight for air in any way (no that would be a clear indicator of a problem and Sam is not so easy to give us the answers) rather he just does not breath.  No it is not apnea...  as the doctor put it "he drowning in his own secretions" ... the goo slides down and stacks up in his throat and as a safe guard his airway closes off.  It is easily fixed... just wake him up! Like I said... Sam had a great DAY.  It is now 1:33 in the morning and I have just satisfied myself that I can now go to sleep and rest assured that Sam will continue to breath throughout the night.  I ran through my usual check list... does he need to be suctioned? Is he breath holding or just breathing really shallow? Does he need oxygen? Any signs of respiratory distress? After I dust off my honorary medical degree, (ha) I give him all his asthma meds and an extra neb. and then I watch.  I watch his chest rise and fall and sometimes give him a little nudge if he appears to be breath holding.  Is he just exhausted or too congested to breath? I suctioned him and watched some more.  His breathing finally slowed and became very calm and even. False alarm.  I determined that it is no where near worrisome enough to call the doctor or to pull out the pulse-ox  but I still needed to watch a bit longer to be sure.  Otherwise I will lie awake in bed for the rest of the night listening through the baby monitor for each breath.  I determined that he is just slightly congested, overly tired and dropping into a very deep sleep and breathing very shallow but his O2 sats are good... crisis averted.  As it is, I will probably get no sleep tonight anyway because I can hear Patrick snoring in the bedroom from where I am sitting at the computer and Sean is stirring looking for a midnight snack.  I am going to get a glass of milk, wind down a bit, check on Sam one last time and head off to bed.  I will be the only one who is tired tomorrow... the boys will wake at the crack of dawn ready for the day.  

And Sam, no doubt, will have another great day tomorrow.