On Saturday, Isaac came downstairs to tell me that Josiah had thrown up in bed. When I got upstairs, Josiah was in the bathroom, and there was a bit of mucous he had thrown up in his bed and also on the bathroom floor. He was very sad and quiet. After he got dressed, he sat at the kitchen table with his head leaning on his hand for so long. He barely ate any cereal (his favorite and typical breakfast). He was coughing off and on and had quite a coughing spell later in the morning that caused him to throw up more mucous again. I kept thinking he just had a cough. I had a routine sonogram on my thyroid in Southlake, and I stopped to buy him cough syrup on the way home. When I got home, he was quietly playing with his new robot from his birthday. I thought he'd get excited if I made macaroni and cheese for lunch, so I started to make that and he laid on the kitchen floor. I texted some friends to ask what symptoms of the flu were for this year and also told my mom he wasn't feeling well. He kept coughing and would barely touch his macaroni and cheese. Josiah has never struggled with breathing problems before, but for some reason (the Holy Spirit!) I grabbed our oximeter and checked his oxygen--it was 88. I lifted his shirt, and he was retracting badly. Dave sensed how serious this was more quickly than I did and said, "If it's serious, you need to take him in." I ran to Dave's office to make an urgent care appointment while everyone grabbed things for us to leave. The kids grabbed Josiah's blanket, his stuffed animals, books, and pizza for me to eat. We hopped in the Suburban and started driving to the Alliance urgent care. In retrospect, I feel badly I didn't think to call an ambulance with his oxygen being so low. I kept an eye on him while we drove and kept him talking before he started to doze off. I asked him, "Do you see horses or cows?" He said, "No, I only see trees." We raced into the clinic and I told the receptionist his stats. The nurse came and met us in the lobby. They didn't even weigh him, but brought him straight into his room and started him on oxygen through a mask. I watched the oximeter shoot straight from 88 to 100! (He went through a tank of oxygen at urgent care.)
The PA said his right lung sounded poorly and asked if he had choked on something that may have caused a collapsed lung. I'm nearly always with Josiah, and I didn't remember him choking at all. Given that nothing has ever been wrong with his breathing or oxygen levels, they initially seemed to think he had a collapsed lung or something lodged in his right lung. He rode in a wheelchair to the imaging room and had an x-ray of us lung (oxygen attached). We came back to the room and my parents joined us. They were a huge help, both emotionally and hands-on-wise.
Josiah's oxygen stayed high as long as he was on oxygen, but they tried to wean him off the oxygen twice (after two sets of breathing treatments), and he dropped into the high 80s again within minutes. This seemed to confirm that it wasn't a breathing issue but some sort of injury/collapsed lung. My dad read and read "Adam Racoon" books to Josiah while we waited. He also threw up badly after his first breathing treatment and then had Zofran. He was pretty zoned out from the Zofran. My dad said that Josiah was a "big shot" and all of a sudden Josiah opened his eyes, started crying, and said, "I don't want a big shot!" The PA told us (and had warned us ahead of time) that there was nothing else they could do for us at the urgent care and we'd need to go by ambulance downtown to Cook's. (His x-ray at urgent care was clear, but they have better imaging downtown at the hospital, so they thought they might find something else there.) My dad cried over Josiah and said, "It's one thing when old people get sick, but it just doesn't seem right when little ones do." He prayed for Josiah. We were all so worried but the Lord gave us so much peace. The PA asked if we knew where it was, and we all chuckled. (This was our EIGHTH visit to the Cook's ER since our second foster baby came in October.)
We left the Cook's urgent care around 4:20 in the Teddy Bear Transport ambulance. Josiah rode in the back with the RN and the paramedic, and I rode up front. (My parents followed in their vehicle and our Suburban.) I kept turning around and seeing how Josiah was doing. I could hear him talking a bit. The RN let him watch a movie. They again tried weaning him off the oxygen, but he immediately dropped to 91. (They stopped him there and turned it back on.)
When we got to the hospital, we went straight through the waiting room and into a room. (One benefit of going via ambulance!) His ER dr was Dr. Nair. He said he would review the initial images and asked again if he may have choked on something that could have become lodged. In the meantime, they did a continuous one hour breathing treatment and then said they'd monitor him for 2 more hours to see how he did. When the respiratory therapist came in to set up his breathing treatment, she said he was going to be admitted to either the regular floor or the ICU. Then, I cried. I knew they were still unsure of the cause and that was why they were considering the ICU. My parents stayed with him a bit while I went to the cafeteria to get something to eat. I kept pondering what our pastor had preached on the Sunday Emma fell off the trampoline from Psalm 50.... "Nothing is mine. Everything is the Lord's."
When I came back, Josiah had thrown up again, but his color was a bit better from the treatment. Dr. Nair said he wasn't concerned about something being in Josiah's lung and believed this was a breathing issue, confirmed that his oxygen stayed between 92-96 after the one hour breathing treatment.
They said we may be able to go home that night, but they wanted him to walk around hallways. Josiah was SO happy to be out of the room! He was skipping and trying to run, and then he'd grab my legs and give me a kiss. When we got back to his room after our second walk, though, he was retracting again. They decided to admit him to observation. 
I'll remember how sweet it was when my dad was telling the nurse, "At home, Josiah has an older brother and sister, and right now their family is taking care of two foster babies." He looked so proud he might burst!
He had an IV port put in, which is standard for admission. It was very late, and my parents were going to take both our vehicles home. Josiah didn't want my mom to leave his bed; the nurse had asked her to sit behind him and help stabilize him while they put the IV line in. He said he wanted someone to "snuggle him." He was so excited though when he found out that he was getting to spend a night with me and sleep in the same room! He crashed after that. When they came to transport him upstairs, I knew he was sleeping so hard that he would have fallen out of the wheelchair, so I carried him all the way to the staff elevators and to his new room on the 6th floor.
His new room was so nice and quiet! He didn't wake up until 5:00 am. The respiratory therapist came in at midnight and assessed his lungs and oxygen levels and was able to put off his next breathing treatment until 1:00am. In his sleep, Josiah put his hand up on the inhaler. When she asked him to put his hand down, he did it right away in his sleep. She said, "I've been doing this for 13 years, and I can always tell which kids are respectful, even in their sleep!" At 5:00am, Josiah woke up and had to use the bathroom. I was very groggy, and it took us a bit to get his IV unhooked. As I tucked him back into bed, he asked if it was still night, and he asked which floor we were on. I told him we were on the sixth floor, and he was quiet for awhile. I thought he had fallen back asleep, but then he said, "When I came the last time to get my chin fixed up, was I on the sixth floor?"
Josiah woke up again at 8:00am to use the bathroom (all those IV fluids!) and reminded me I had to unhook the IV line first. We ordered breakfast, and when it came we set him up in bed with his scrambled eggs (he called them "boiled eggs") and pancake. He didn't see that I had a tray over on the couch. I was cutting up his food and trying to think straight when he said, "I can share my breakfast with you!" I told him I had a tray, too. He ate so well and so quickly--he really hadn't eaten anything since Friday! I told him it was nice to have breakfast with him. Neither of us talked very much, and after a quiet spell he said, "It's nice to have breakfast with you!"
Our nurse, Kimberley, knew two of my friends who had gone to Keystone. She was so wonderful with Josiah! He was so intrigued by her stethoscope and she gave him his own to take home! When the nurse practitioner came in to check him over for discharge, he said, "Every one who comes in here listens to my lungs!" He also told the nurse, "My brother Isaac has allergies to things outside" when she asked me if Josiah had any allergies.
We read a lot from our huge Berenstain Bear science book and the Adam Raccoon books. I laid with Josiah in bed for awhile while we waited for discharge and he watched CARS. (I slept a bit.) By this point, he was talking a lot, his color was great, and he was able to space his breathing treatments out to every 4 hours. Since he had thrown up all over his clothes the day before, he didn't have any clothes. They had a new pair of pajamas that were donated for him to wear home. He walked all the way to the ER entrance, and then I had to carry him because he didn't have shoes. When we climbed the stairs in the parking garage, he was worried about the open stairs. He asked, "Is this the same place as when we went to the service with all the instruments?" (He was referring to the parking garage we parked in when we went to the FW Symphony.)
We came home around 1:00 pm. My parents were here with Dave and the kids. When we pulled into the driveway, Josiah said, "Can we sing 'Happy Birthday' to celebrate my return home?"
We love this boy so much! We are so thankful for such a quick response to the meds, for the Lord's protection over him as we drove to urgent care, and for all the love and prayers we received! Praise the Lord!
