This isn’t always what we think of with flu, but it can be a matter of life and death
Do you want to hear about the scariest day of my life? It began very early on December 19, 2019. My sweet little towheaded 5-year-old boy had the flu, which had developed into pneumonia. We had been transferred from our local ER to UK Children’s Hospital, and every step along the way he had progressively gotten worse. I watched as the supplemental oxygen he was receiving through a nasal cannula was dialed up from 1 liter to 3, then to 5, 7, and finally, once we had been admitted to his hospital room, up to 10. It was as high as it went. From one little port in his arm went a variety of medicines: IV Tamiflu, antibiotics, steroids. Along with oxygen, he received a continuous nebulizer of medicines designed to help keep his airways open.
My son was hooked up to a machine that monitored how much oxygen was in his blood stream. Healthy is 95 or above, and I watched as it fluctuated between the 80’s and low 90’s. I knew that was not good, especially as it took more and more oxygen to keep him at these low levels. I touched base anxiously with my husband, who was at home caring for our older child who was also sick.
And then, right at 1:15am, my little boy cried out in pain. The warning beeps of the hospital machinery began in earnest. I watched as his oxygen saturation went down, down, down, all the way to 69. I cried out to him as he lost consciousness and the color drained from his skin. His lips were blue. All around me the room filled up with doctors and nurses in their aprons and masks, working urgently to stabilize his oxygen. They used a variety of masks and equipment and added medication to his IV, but most of it was just a blur to me. Maybe they gave him a shot? I’m still unsure. I laid on the foot of his bed, just holding his hand and trying to talk to him, to reassure him and stay out of the way of the people around me hard at work. He had been awake right before this happened, and I kept trying to get his eyes to open up and focus. Every few seconds I would look away from him to try and see line that charted his oxygen through the sea of people. I was doing my best not to panic, not to think about how long his brain was being shorted of oxygen. I started to sing him his favorite bedtime song, but my voice caught in my throat. It struck me that I did not want to sing him to sleep. It took every bit of my will not to vomit.
Right when his oxygen began to stabilize in the 80’s the Attending Pediatrician shouted out that he was calling this a case for the Pediatric Intensive Care Unit (PICU). They hooked up the new oxygen system they had brought in to his bed along with all the other equipment and rolled him down the hallway with me following along. Someone explained to me that the PICU was full or they would have moved him even sooner. They had moved another child out to make space. I was so worried and confused. I remember thinking, could it be bad enough to move someone else from PICU? In my mind I had held onto a sliver of hope that our situation was not that bad because at least we weren’t in the PICU. I asked the nurse if it was over, and I could tell by the look on her face that my question surprised her. I was trying to understand if his oxygen drop was a single episode, was he now okay? But he clearly was not.
In the PICU
In his room in the PICU they set up what I learned was a high-flow nasal cannula. This was a big, thick tube that noisily forced air into his body. The highest the oxygen went in a regular hospital room was 10, and here he was on 30 liters of pure oxygen, forced into his body. He was also receiving the continuous nebulizer along with a whole new slew of IV medications. Somewhere along the way they had connected all kinds of patches and wires to his chest and neck. There he was, his little body overshadowed by the hospital bed and the equipment. He was either unconscious or asleep, his mouth open and his lips cracked. And I lay next to him. From the moment we entered the PICU they had set me up to be with him on the bed. I was exhausted, but every bit of sleep I got I woke up from in snatches to watch his oxygen on the monitor. I remember watching the line, praying for it to get back up to 94, but it still vacillated between the high 80’s and the low 90’s. Every time it dipped below 90, the machine called out a warning. Every time I braced myself, terrified that his oxygen might drop again.
At 4:00am the Attending of the PICU came to our room. She showed me a very concerning x-ray that showed his right lung dropped from its rightful place. All along his chest and his neck were splotches of escaped oxygen that even I, with no background or training, could clearly see on the film. She explained subcutaneous emphysema to me, and pneumomediastinum: his lung had been so inflamed and blocked with mucus that it had “popped” or collapsed from his struggles to breathe, leaking oxygen out his body and into his chest cavity. She explained to me that he was stable, but that his condition was still very serious. His little body had to fight off the flu, pneumonia, and an asthma exacerbation. His lung had to heal, and his body had to reabsorb the escaped oxygen and gasses. He was in the right place, and they would take the best possible care of him, but we would have to watch carefully to see how he progressed.
I have had some low moments in hospitals. I was in a hospital when my mother was released home to die after a last-chance chemotherapy caused her organs to shut down. Then, less than 2 months after her death, I was alone in an ER bathroom at the Pineville Hospital when I delivered the tiniest baby, 16 weeks old and completely still. I was certain at that moment that my life had hit its lowest point. I had never needed my mother more, had never felt a grief so total and so piercing. But nobody can tell you the complete physical, spiritual, and emotional trauma of watching your bright and active 5-year-old, uncertain if he is going to live. It was beyond anything, totally unworldly and out-of-body. It was a fear beyond expression.
But I was also in shock. This severe reaction to the flu was a complete surprise. Sure, this little guy had a few struggles with wheezing here and there when he got an upper respiratory infection. He had been on a few rounds of prednisone before—maybe once a year. But he had always been so resilient to illness, popping right back up and recovering quickly. He is a total boy’s boy who loves to run and jump and never lets anything slow him down. I could not believe that was my child was there, fighting for his life. I had never seen how clearly the battle is drawn between the force of illness and the capacity of a child’s body in the face of such an attack. I had never sat in agony, wondering if a child who was happily playing a few days earlier would every get up from his hospital bed, ever play again or grow. If he had a future.
For hours I lay beside him, trying to soak up every piece of him I could. I thought about how excited he had been when he turned five earlier that month, waking up just certain that he was taller and smarter than he had been the day before when he was only four. I thought about the sweet way he told me he loved me every night, saying “you’re the best Mommy.” I watched his throat as he retracted with each breath, his entire body working to breath, and I prayed fervent prayers.
And then, he reached his hand over to me. His oxygen saturation went up to 94, then 97, then 99. And it held.
In one blessed moment he roused and asked for water. I felt the pure adrenaline joy of the feeling that he was going to make it. I am not sure if I have ever felt so physically relieved and happy in my whole life. I was sure that with a full PICU we would be let out right away, but I was told that this was not the kind of case they released early from the PICU. Someone explained to me that his progress was a good sign, but that the night ahead of us would be the major test. He needed another full night on the high-flow nasal cannula as his body reabsorbed the extra air under his skin, with a watchful eye to see if his condition worsened again.
But through the night he only showed improvement. When morning came he managed to sit up and eat ice cream in bed. He was weak and grouchy but he had no fever. He was weaned from the high-flow nasal cannula and we were able to take a walk around the PICU floor. Then he was released from PICU back to a regular hospital room. He still needed supplemental oxygen, but only a liter or so. His improvements progressed just as rapidly as he had declined and he was able to come completely off oxygen, to return to a normal treatment regimen for a child who has had an asthma flair. The talk turned to discharge. We were able to leave the hospital in time for Christmas at home.
If you have read this far, you may still be wondering, what was the trick? How did he walk away from an illness so severe? I can promise you that what saved his life from the flu was, in fact, a flu shot.
You may wonder how I could credit a flu shot. You may even be shocked to hear that he had been immunized. And he still got the flu? You have to understand that the flu shot doesn’t always prevent the illness, but instead lessens the severity and duration. And this makes perfect sense in his case. The course of his illness was initially very mild – he had a slight fever off and on for a few days. The day before we ended up in the hospital, I felt like I should have gone ahead and sent him to school. His recovery was remarkably fast, and it is hard to credit Tamiflu since he had already been sick for 4 days before it was begun. While he was recovering from a collapsed lung, his flu symptoms again were very mild, and his body was not burdened with a high fever or additional inflammation or mucus. In the deadliest flu season in 40 years, my son had quite a bit of protection from the flu thanks to his flu shot, and that tipped the balance in his favor.
When I was with him in the hospital I replayed again and again in my mind when and how he got a flu shot. I just knew that I would never have forgiven myself if he hadn’t had one. And I thought to myself that if we made it out, it would be my obligation to share this testimony.
I pray that you and your family are never in a situation like this one. But the flu season is long. It can extend all the way into May in a bad year. And even if you escape an experience like this one, there are so many others out there who already walk the balance of life and death and who depend on us not to get the illness and pass it on. Children with cancer. The elderly. New and tiny and fragile babies.
If this story nudges even one person to consider the flu shot with new eyes, I feel that I have met my obligation. We received so many prayers while we were in the hospital, and they truly got me through my darkest hour. But, oh, how I was humbled when we walked away, knowing so many children we left behind in the hospital whose prayers were still not answered. It does not take long in the PICU to realize that families out there live their worst nightmares, and the unthinkable does happen. This year a record of 28 children in the U.S. have died from the flu. So many of these deaths were sudden, unexpected. I cannot even begin to imagine the pain of losing a child. My small glimpse only showed me how vast and unfathomable is such pain and grief.
I am someone who believes that our job on Earth is to be as loving as we can. If you choose not to get a flu shot, I won’t hate you or think less of you. If you have made up your mind that flu shots are bad, this story may not be for you. This story is for the momma who feels uncertain about whether or not a flu shot is the right choice. This story is for the family who has just been so busy it has been hard to fit in. To those people I would say, our world has grown and changed so fast. We buy groceries shipped in from all parts of the world, and we touch restaurant tables and gymnasium bleachers that have already seen so many people. To me, a flu shot is a lot like putting on a seat belt, or buckling a child into a car seat. We get into cars every day and hope they are not needed. But we are prepared for the worst-case scenario, knowing we are far more likely to walk away with that protection. And just like I would never drive without a safety belt, you will never catch my children without their annual flu shot.
Now that you know a little bit of what it is like to have a critically ill child, I hope you can make your choice with a heart that feels some peace. I am so grateful for the health and life of my sweet little boy, and for the many people who prayed for us. I am beyond thankful to the many skilled practitioners who watched over him and took care of us, and for the remarkable advancements in medicine that kept him breathing. But I also pray that his close call might prevent another family from this kind of situation. Maybe it will be yours?
Home! With the puppy he got for Christmas