Something New...

Tachypnea...that's a fancy word for rapid, shallow breathing

So, when Emmie was a day or so old, Mark and I commented about how fast it seemed she was breathing.  We knew that breathing rates varied and we just chalked it up to being newborn and that it would streamline at some point and get slower.  Also, doctors did not seem to notice it during all her checks.

A week and half went by and I continued to notice her breathing was rather rapid still.  I never observed it being slow either.  And so I finally decided to time it.  The first time was 60 breaths in 1 minute.  A bit high but still within normal range.  The next day, I checked it and it was between 80-90 breaths per minute.  Not normal, and I know I missed some breaths because it was so fast.  Later that morning, I counted again.  112.  Definitely out of range.  And then later back down in the 80s.

Finally, by late afternoon, I called our pediatrician.  Let me just say, Dr. B is awesome.  She is not only our kids doctor, but I consider her a friend.  She has always told us to call if we ever need anything.  So, I did the next best thing, I texted to make sure she wasn't busy.  Then I called.  She was not happy with what I was telling her and she wanted to have her checked out (Dr. B is usually pretty laid back so when she gets concerned so do we).  It was Sunday and everything was closed.  That meant we had to head to the emergency room.  Our first trip ever to the ER with a kid. I have no clue how that happened.

We scrambled for childcare and grabbed what we thought we might need and headed out.  This is where amazing friends come in.  I called our pastor's wife who was hosting care group that evening and asked her to come over.  She dropped everything and came.  Then I got in touch with Kristina and told her to relieve our pastor's wife as soon as possible.  I didn't ask.  Just told.  And she did.  We also had Tracy lined up should it get too late.  I kept thanking God over and over for putting people in our life who were just like family.

The ER didn't provide much answers but they did confirm she was breathing fast.  They were not too concerned about infection because her pulse/ox level was 100%.  Her heart sounded good.  She had great color.  The only conerns were that her cap refills (capillary on a leg or arm firmly and then count to see how long the color takes to return) was slow by a couple of seconds and her breathing was fast.  That proved not to be too much of a concern because it wasn't staying consistently fast. It was 100 breaths per minute one time and then down to 75 at another or even 60 and then back up.  They chose not to draw blood because she did not present enough reasons to indicate an infection.  They did a chest x-ray to make sure her heart and lungs were normal size and those came back fine.  They discharged us that evening with advice to follow up with Dr. B.

All the while, we were texting Dr. B and the supervising ER doctor was talking to her as well.  She was happy with all their results but still wanted to lay eyes on her.  So, the next day, Memorial Day, Dr. B met us at her office (which was closed due to the holiday).  She was super glad to have checked her out and Emmie was doing great.  The only red flag warning was the rapid breathing.  Her cap refills even improved (she said they could have been slow due to a cold room etc).  Because the breathing was now the only concern, she opted to just follow her closely and not do any more tests.

We do have much more peace of mind and are prayerful that it's just taking her autonomic system a bit longer to get in to the swing of things.

We have a lot of reasons to praise God for his protection and provision through all of this:
1.  We were a little lost going through the ER process and figuring out what to do etc.  We thank God that this was our first ER-kid trip when some parents have to walk this road regularly for various reasons.
2.  While waiting in our room, we heard a little boy screaming in agony over a broken bone.  My heart broke for all the pain he was in and I whispered a prayer of thanks that we have yet to have one of those.
3.  We are blessed to live in a town with a children's hospital attached to a large hospital.  We didn't realize that there was a specialized pediatric ER.  The staff were amazingly patient and very knowledgeable and very mindful of having a 2 week old in a germy place.
4.  Again, the Lord has put amazing people in our lives who don't ask questions and just do and pray when we need it.
5.  The Lord has also blessed us with wonderful doctors who work on off days or after hours to help make sure our family is well taken care of.

After our ordeal, we informed Emmie that if she wanted us to go on a date, she just had to say so and not plan it for the ER.  Mark and I were able to breathe easier and relax a bit after we realized it wasn't as much an emergency as we thought.  So a bit of uninterrupted conversation was a nice respite and we quickly went through our mental lists of everything we've been needing to talk about while waiting for doctors and tests and such.

Thursday 5/29 Update:

Dr. B checked out Emmie again.  While we did catch her breathing rate down in the 50s at one point between Monday and now, I only caught it down there once.  Every other time it was ranging from mid 60s to 70s and then this morning I clocked it at 90 breaths per minute.  Dr. B examined Emmie and informed us that after some more research she did find a diagnosis of idiopathic tachypnea which is basically just an unexplained rapid breathing that resolves on it's own.

Being ever cautious, though, she said she would consult with a pulmonologist to ensure she wasn't missing something and get back with me.

And the result from that is:

So, the pulmonologist said that two things she looks for in rapid breathing infants.
1.  A kidney dysfunction.  I can't remember the name of it but it can be detected by a blood test.  Dr. B said that she wasn't too concerned that it was that because babies don't grow and it's pretty obvious Emmie is growing (weighed 10 lbs 15 oz on Monday and today was 11 lbs 4 oz.).  However, it's a simple blood test to rule it out and since we are doing that, Dr B also wants to do a CBC to rule out infection.  

2.  Silent aspiration.  The pulmonologist said that she sees this a lot in infants who just present with rapid breathing.  To rule this out, we have to do a modified barium swallow. Which means somehow we'll have to introduce a bottle to her.  Our first and last child to take a bottle was Zoe when she was four weeks old because I had gallbladder surgery and we had to wait a tad before she could nurse.  It was one bottle.  I, honestly, am more nervous about trying to give her a bottle, especially when we are just now getting a good nursing routine and because I haven't a clue how to do it.

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