What a weekend. Friday night, Christopher's breathing became quite bad, despite our earlier trip to the pediatrician that day to start in on steroids for his asthma. We gave him a nebulizer at home at 1:30 am, but by 2:30am he wasn't doing better. After my "scared straight" speech from the pediatrician, I decided to take him to the ER still wondering if it truly constituted an emergency as I drove the vacant streets at 2:30 am.

The ER doctor didn't wonder -- she said it was definately the right call to bring him in. He was in distress. His oxygen saturation levels weren't good, he looked pale, and his breathing was quite constricted, especially when listening with a stethoscope. I realized that this night wasn't much different than many other nights of listening to poor breathing -- what had changed was my action due to the pediatrician's "scared straight" speech. I realized that my perception of trying to avoid an ER visit by treating him at home was the wrong outcome. I should have been trying to treat him where he'd do best, which was probably at the ER.

After 2 rounds of nebulizers at the ER, he wasn't showing improvement. The doctor started preparing me for the likelihood of a hospitalization. She said they could try two more rounds of nebulizer, plus add pure oxygen in between treatments in an attempt to get his stats higher, but that if they didn't work, they would need to admit him. I was appalled not just that my boy was in such trouble right then, or the realization of just how many other nights at home he was in the same amount of trouble without the help of medical professionals, but that I had just completely lost the boat and not realized then or even tonight before bringing him in just what bad shape he was in.

Fortunately, the oxygen and extra nebulizers helped enough to allow us to go home at around 7am. I've been the overprotective mom all weekend trying to stop him from running or riding his bike in attempts to get him 100% -- he's not there yet. He feels better enough to want to have fun, but not well enough to make me feel comfortable letting him.

So, things I've learned in the past few days:

1. We have to do a peak flow meter reading every day -- not just when he's having trouble. That way we'll know a good baseline and will see declines as they come gradually, rather than waiting to see him hit bottom with visible symptoms.
2. Having the goal of avoiding an ER visit only works as a reasonable outcome if we're doing the peak flow meter readings. It's really only with those early signs that we can and should try to avoid the ER. Once I see the visible signs, it's too late to try to manage it home. Otherwise, I need to think of the ER as my friend.
3. With other diseases, I might watch symptoms over a few days to decide whether a physician is needed. I don't run to the doctor's office at the first sign of snot -- I'll wait a week or two and see if the body fights the germs itself. If there's no improvement after a reasonable amount of time, I'll seek medical attention. That's fine for most things, but not asthma. I need to change my paradigm. At the first sign of distress, we need to see a doctor. It won't improve, the body can't fight it just on its own. And it shouldn't have to try -- it's too dangerous.

I've been hitting myself over the head feeling bad about my lack of management of Christopher's asthma. It's my bad mother guilt. I guess it's time to stop feeling guilty about it and hop into action to make sure we get him healthy in the short run and long run.