I started hearing a weird clearing of throat from Gar a few days ago, but dismissed it. He was rather lethargic on Wednesday evening, and laid flat on the rubber playmat. It was only on Thursday early morning, when I was feeding him when I heard a very scary loud seal breathing sound. He was heaving with every breath, and after he went back to sleep, the snoring or laboured breathing continued. I told my domestic helper to tell my mother to bring him to see the doctor, which she did.
Unfortunately, as the paeditrician did not hear the sounds, and my mother did not know about the laboured breathing, she said it was a sore throat. However, in the afternoon, his temperature spiked to 38.6 degree Celsius, and he continued to make the loud sounds while feeding. The clinic was not opened in the evening, and I decided to bring him to the hospital. However, my husband did not want to do so, so he found another children’s clinic that was opened in the area at night. I pushed him in the stroller to the clinic, and we were greeted by the sight of a near empty clinic, a huge difference from his usual paeditrician’s, which was teeming with people.
The place was slightly stuck in the past in terms of décor. It was slightly dim, and a large note stated that only cash was accepted. The nurse brought us to a room, where she took Gar’s temperature and measured his weight. He refused to sit on the baby weighing scale, so we had to do displacement, and had a rough number. He managed to stand, and he was about 72-75cm.
The paeditrician was an elderly doctor, who listened intently to him. She was not rushed at all in her diagnosis. After a few questions, she told me that I should bring him to the hospital. She showed me a diagram of the windpipe, and pointed to a section (stridor) that she said was swollen, and hence his breathing was laboured. One of the worries was lack of oxygen, so the hospital could monitor him better. I did not see the seriousness of it, and thought she said that I was to bring him to the hospital only if the situation worsened. She wrote a letter for me to pass to the emergency department. She said if we did not want to bring him to the hospital, she would provide some cortisteriods which he could take, but only three doses were allowed. I decided to bring him to the hospital instead. Rummaging through her desk, she could not find an envelope, and hence told her nurse to bring a few in. Finally, she put the letter into her envelope and I took it after paying at the counter.
A younger receptionist was more interested in the exchange rate of the Thai baht, and I used my google search to tell her the sum. She wanted the exact rate according to her, but I told her she could use the sum I gave her as a guide on whether she should divide or multiply in the conversion. I asked for a receipt, but the other nurse was not very familiar with the computer and had to ask for help.
When we reached home, I quickly packed a number of diapers, some of Gar’s clothes, bottles and milk powder, but could not find my jacket. At first I thought that we should have gone to the hospital immediately, but on hindsight, the letter had saved us a lot of waiting time, as she had properly diagnosed the problem, and the nurses on duty had seen it urgent enough for us to skip the super long queues at the emergency counter, right to the doctors on duty.
The doctor who attended to us asked us a few questions. He was probably a fresh houseman or a newbie, as there were two other doctors who checked on him, including a senior consultant, most probably in his thirties. He told us that they would provide treatment, and then observe whether he was responding to the treatment. If not, he would be admitted. At the observation ward, there were other children who had respiratory problems, or some who were crying non-stop. I overheard a lady busy applying for leave from her company, and then telling her husband that they should go for B1 ward, because she would die without television. She said that they could claim insurance any way. I felt I was judging her, but simply kept the thoughts to myself.
After waiting, Gar was giving neubralizer. He resisted initially, but accepted the mask over his face soon. An hour later, Gar’s temperature hit 39.1 degree Celsius, and we were told to sponge him after he had a dose of panadol. I did not want to wait in the waiting area, where there were many other sick children, so we went outside, near the driveway where people waited for the shuttle during the day. We sponged his forehead, his armpits, body, back and neck repeatedly for half an hour, before reporting back. His temperature only went down slightly to 39.0 degrees.
The nurse wanted us to continue monitoring, but the young doctor called us back to say that Gar was not responding to treatment, and he would arrange for admittance immediately. The senior consultant checked him too, and asked whether the doctor had asked every question. I overheard them referring to us as the ‘stridor case’.
At the registration counter, I went to register, but had forgotten to bring his birth certificate. They sent Gar to take two X-rays. We had to choose the wards, and I went for B1, a ward of four beds with air-conditioning. I chose this over the other cheaper wards because of air-conditioning. It might get very warm at the other wards, and the more beds there were, the noisier it would get. I did not really pay attention to the total cost of the wards, but the receptionist said that he would be treated as a private patient in the future. We ended up running to and back to get this done. A man with long permed hair and a thick moustache brought us to the ward on the topmost floor. Apart from the four-bedders, there were single-bedders too. Does this also mean that the children on this level get better attention? I did not think much about it at that time.
It was past one o’clock. We finally had a bed, and I stayed on and slept on a foldable bed that was quite comfortable. Unfortunately, it was extremely cold, and I was freezing throughout. At about 2.30am, two young pretty female medical officers (MOs) came to check on Gar. They asked a lot of questions, including what type of birth I had, how heavy he was and many others. I wondered how some of these questions would affect the treatment. The nurses also came and provided treatment. They also took swabs from his nose. I woke up to see Gar with a plastic transparent box over his head for some oxygen or something to open his airways. He was asleep.
The next morning, the nurses tried to put the box again, but this time he was awake. He was extremely strong, and he pushed the box up. He struggled a lot, and we finally wrapped him up and held his arms down. We put a few of his favourite cards to distract him. Some nurses used their phones to show cartoons to let him watch, but he did not like those. It was nerve-racking to hear his unusually high-pitched cries, followed by very laboured breathing.
At first, I thought that Gar would only be admitted for a day, as that was what the doctor at the A&E said. When the doctors told me they would be observing him the night, I thought to myself, what was one more night. My parents came over for a while, and then I waited for my husband and the helper to come over. When they appeared, I went home to take a shower, and sleep. I went back at four o’clock. Apparently Gar did not eat much or drink much milk. I was still breastfeeding him, so I fed him, which he wanted. The nurses kept asking me how much milk he took, how long he was breastfed, and how much food he had eaten. They were worried about dehydration. His lips were dry, but his tongue was still moist. They would keep close monitoring on this, as his bad throat made it difficult for him to feed. If he was dehydrated, they would put him on a drip. I was very much against this, as I knew that this physically strong boy would definitely pull the tubes out, or struggle so much that the tubes might be ripped out of his veins. However, as I was already cutting down on breastfeeding, he probably did not get much milk.
The patients in the wards were older than Gar. One was a girl from an East Asian country. Another was from a Southeast Asian country. Most of them had various forms of fever, so I was worried about cross infections. Most of them were discharged after a day or two. One night, I overheard a boy asking why his mother was crying. After some probbing, she revealed that her colleague died in a surgery for heart bypass. One patient had an apparent serious health issue, and the doctors were not really sure that it was that. They were just doing as many tests to come to a conclusion.
Every day, the younger doctors would update the big entourage of doctors about the different cases, and the senior consultants would come and check on the patients. The younger doctors would decide on the course of treatment, and the senior consultants would confirm these, or ask them whether they had considered other things. I guess this is a rite of passage for new doctors. I also noticed that the female doctors were well-dressed and they carried sling handbags wherever they went.
The nurses were very helpful. They were professional, and I could see that they cared for the patients. They helped to make milk for him, and they checked on him constantly. Unfortunately, Gar started to recognise the nurses and the doctors, so whenever he saw them, he would try to make his escape, especially if he had been outside walking about. In fact, he was quite upset once and he nearly hit a doctor.
When it came to my meals, I would usually wait for my parents to come in the morning, before I had my breakfast. On a few occasions, I ate what my son had left untouched. Most of the time, I had a cup of milo. The food at the food court was decent. I had roti prata with banana on one occasion, and or char kway on another occasion. The Japanese food was not too bad. There was also pancakes and soybean. I quite liked the microwavable pasta sold at a local convenience stall. I could not get the microwave to work properly at the pantry in the ward on the first day though.
In the afternoons when I could go home, I would sleep for two hours. However, on one day, my mother-in-law called me up and wanted to go and visit Gar while El was sleeping, so my sleep was interrupted. I did not take my multi-vitamins too. I was also not fully prepared as I had gone back later that day. On the fourth day, they kept delaying Gar’s discharge, so I finally went home in the evening. By then, my energy was really spent. By the time I woke up, it was 8.30pm. I think that was also the day when I started to feel a little lousy.
On some days, Gar was very tired. On other days, he was wide awake, and was walking briskly around the ward and in the corridors. He also kept talking about buses. He usually struggled at the bathing area. He refused to stand and bathe, and clamoured to get out. He wore the patient gown on some days, but they did not provide changes that often, so he also wore his own clothes. We also could not get him to eat much. One time, we held him down, and distracted him, and managed to get him to finish one third of his porridge. On days when it did not work, he ate nothing.
At night, it was a herculean effort to get him to sleep. He must have been very uncomfortable, so the moment I tried to put him down on the bed, he would cry and wake up. There was one night when I had to sit on the foldable bed, carry him in my arms, let his head touch my knee, so that he would get used to having something to support his head. On many occasions, he would sleep for half an hour to one, and then cry and wake up. I had to keep lowering and pulling up the baby cot.
On Sunday, a two-year-old was admitted. He had a few frightening episodes, which my helper was extremely nosey about and she updated me. The parents were so concerned, they spent almost every waking moment talking about him. They had visitors constantly, and even after the lights were out, they continued talking non-stop loudly. I was extremely irritable, especially after a few days at the hospital. They kept using sweets to bribe the child to go for various treatments. I could understand if the child was wide awake, but I could not understand why they needed to talk to him constantly. With the sugar rush, he would definitely be very energetic. The boy was afraid of darkness, so they left the TV on, and the volume too. The next morning, another steady stream of loud-mouthed visitors came. I really did not need to know exactly what had happened and how the mother was unable to prevent the incident and how scary the episodes had been for them. It was like having a Facebook or Twitter account where every single detail was broadcasted every few minutes and reposted, aloud. Thank goodness the couple were tired out on the second night, so they were finally quiet for once, and I could rest properly, which I thoroughly needed after four to five days at the hospital.
By the fourth day, the stridor sound had gone, but there was still some heavy breathing. They had been monitoring his oxygen level, and heart rate. It was frightening to see his heart rate going up to 190 beats per minute, especially when he was agitated. He would also turn in his sleep, and the oxygen level would fall below 92%. It was amazing how a little electrode could monitor all these from his big toe. Of course, he hated this wire, and would tug at it constantly. When I had to carry him, I had to make sure his toe was not being tugged at. It was only on the last night when he did not have to have any machines monitoring him. He was also given the final dose which the elderly paeditrician had warned about. The new senior consultant on duty did not allow him to be discharged on the fourth day, so I had to continue waiting.
Apart from the young doctors, there were final-year medical students too. They seemed to be very interested in Gar’s stridor breathing. They appeared on various occasions to listen to him. I guess you need experience to identify the various sounds and the pulses.
There were a few announcements made over the course of the nights I was there. On one night, the fire alarm went off. Immediately I put my glasses on, and wondered whether to take my wallet and carry Gar if a need arose. On another night, I heard an announcement on Code Blue, and the medical officers were all supposed to report to the emergency re-sus room. I had heard about Code Blue before. I immediately googled it and it was a case where a child had either a cardiac arrest or was not breathing, and hence required resuscitation. I also found out that there were various codes, such as codes for fires, infant abduction, and others. Unfortunately, there was no way to find out whether the child survived that incident.
They had a name for Gar’s condition. At first they said it was croup, which I found out was some upper respiratory problem, with flu-like infection. The first signs would included a seal like breathing. The new consultant said that Gar suffered from a virus named Parainfluenza Type 1, which was very serious in infants and young children, and hence he was required to be hospitalized for so many days. This virus would attack the vocal cords badly. Perhaps he got the virus from his father who had totally lost his voice for a few days a week or two ago, or he got it from El who was coughing right into his mouth the night before his admission. I have no idea.
After the longest time, he was finally discharged on Tuesday. Unfortunately while waiting for his the doctors to make their rounds, he tripped over the metal legs of a table, and fell flat on his face, resulting in blood from the nose and lips. They recorded this incident. It was another hour or two of waiting. I have no idea how much the hospital bill would come up to, but I think it should be more than 1k. They said they would send the bill to us two weeks later.
Throughout the whole episode, I did not see my elder son, and he actually told me he did not miss me. I am now feeling extremely tired, and had a very bad throat, and I could not take any of the medicine prescribed because I am still breastfeeding. I guess water is my best friend at the moment. It is back to a world of work and more work that had been piling up over the weekend. I really hope that my children would stay healthy.