Admitted to SickKids

Ty was admitted to SickKids yesterday. It’s very hard to make a long story short without including all the details because he has a lot going on right now, but basically after a period of hematemesis and extremely low oxygen levels at home yesterday morning, I had to call 911. The ambulance brought him to Headwaters where they did bloodwork, a chest xray, put him on IV fluids and antibiotics, and then transferred him to SickKids. Once at SickKids, he had to go through emerg to decide which department they were admitting him to. He ended up on 7D, the general pediatrics ward (not the cardiac ward as much as I tried to advocate for.) We didn’t get to 7D until 10:00pm so it was an extremely long day. By evening he was already looking much better so it was clear that the IV fluids and antibiotics were helping him. He didn’t have an amazing night’s sleep but the first night is always rough.

This morning when the pediatric team did their rounds, I questioned their diagnosis of pneumonia because Tyson hasn’t been coughing any worse or more than what he has been for the past several months. And the vomiting wasn’t brought on by a cough at all, he literally woke up feeling nauseous and that’s how it started. The staff paeds doctor said that the xray showed an 'aspiration pneumonia,' which is different from a viral/bacterial pneumonia, so it wouldn’t necessarily produce a cough the same way as his usual pneumonia.They think that when he was puking yesterday, he likely aspirated into his lungs and that's what caused his O2 sats to tank so badly. Bloodwork also found increased white blood cells, particularly neutrophils, which indicates some sort of bacterial infection. So given his respiratory history, they’re treating him with IV antibiotics and oxygen. 

Today he’s looking very well! He’s in good spirits and wants to go home. He honestly looks like he could just put his shoes on and go home right now. But they ran a bunch more tests today and asked about a thousand questions about what happened yesterday, and have decided to keep him for another night for observation. Given the extensive MRI findings with increased liver congestion, and the unexplained hematemesis, they really want to make sure they’re not missing anything. (I’ll save the liver MRI findings for another time.) Right now nobody can explain the hematemesis so they want to get to the bottom of it before sending him home. And we want this too, because the last thing we want is to go home prematurely only to have to come back next week with the same thing. We have a wedding to celebrate next week so we want to be sure he’s 100% ready to go home and can stay home!

We’ve seen about 20 fellows and resident doctors today from multiple teams. The paeds team, infectious disease team, cardiology team and respirology team all came by a few times and are digging into what could have been the cause of the hematemesis.  

With respect to the chronic cough he’s had for the past several months, the respirology team wants to wiggle their way back into his life. They were a big part of his care from 2011-2016 when he had asthma and recurring pneumonia. They ordered a sputum culture so they can evaluate if there’s a viral, bacterial, or fungal aspect to this cough. (Plastic bronchitis, a side effect of the Fontan, is always a concern in the back of my mind, so hopefully it’s not that!) And later as outpatient, he'll be going for a chest CT scan and a pulmonary function test. The respirologist says those can wait till after the wedding 🙃

So we are here one more night for sure, with the plan to go home tomorrow as long as everything goes well. There are still some unanswered questions, but our cardiologist is going to call next week to explain the findings from his liver MRI and heart MRI that Ty had done last week. And we will follow-up with the respirology team to see if we can do something about this chronic cough. 

Thank you for all your prayers, they are greatly appreciated. We will update you about the MRI findings another time once our cardiologist has a chance to explain everything to us.