Why were we in the hospital?

D had an empyema. {An empyema is a collection of pus within a naturally existing anatomical cavity, such as the lung parenchyma. It must be differentiated from an abscess, which is a collection of pus in a newly formed cavity. Usually an empyema starts with pneumonia, followed by a parapneumonic effusion. This effusion, which starts out sterile, then becomes infected. As the infection progresses, the thickness of the fluid increases, going from a broth type consistency to concrete. When the fluid is still free flowing, it can be treated with a thoracentesis or a chest tube. When it thickens, it can usually be treated with thoracoscopy (Video Assisted Thoracic Surgery; VATS). Once the fluid becomes thick and loculated, a formal thoracic surgical procedure called a thoracotomy with decortication is required. This involves opening the chest, taking out the fluid, peeling the thick rind of infectious material off the lung, and then inserting chest tubes while the infection clears (usually with the help of antibiotics). Chest tubes in the setting of empyema have a tendency to become clogged. Chest tube clogging in the setting of an empyema can lead to re-accumulation of pus and infected material, a worsening clincial picture, organ failure and even death. Thus managing chest tube clogging is particularly important after the treatment of an empyema.} this info. is from a web site In our case the empyema was fluid enough to drain with a chest tube and not the thoracoscopy. The empyema was causing the lungs to push on the heart and the condition was initially very serious. Back a few hours before the hospital. We had only noticed a high fever and lack of appetite for a few days. The doctor's office initially found nothing serious wrong. They suggested a chest x ray as a precautionary measure, "Just to be safe." Right after the x ray, it began to unfold that this would be a hospital trip. The x ray showed all the fluid, and we were told to head directly to the hospital. Both the hospital and the doctor's office agreed he was a lot worse than he sounded. The x ray was critical to show how sick he really was. At the hospital, this condition was the highest priority (the fluid caused his lungs to push on his heart and he had severe shortness of breath) and rushed right through the ER. The chest tube was put in not long after the earlier doctor's appointment. Now the chest tube is out and we are continuing antibiotics for several weeks. From start to finish D was the bravest kid the nurses had seen. After oxygen, feeding tubes, a tube to his stomach in the other side of his nose to release pressure, and a few enemas, not to mention the painful chest tube and numerous x rays and a picc line replacing the initial iv, along with several blood tests, he proved to be extremely brave. Some of the procedures took only minutes instead of an hour because he was so still and cooperative and some they did with him not sedated or pinned down like they were used to. I am put to shame with the degree of courage he showed. In the end I am happy we had a hospital that could take care of his condition. I think it is a miracle our local pediatrician suggested the x ray. I marvel at technology. I am at a loss for words at the thought of a sick or dying child. I feel so thankful to have our sweet little D feeling better. You wouldn't know he recently had so much trauma in his life. Right after a particularly hard day he was given some oreos. He ate them and smiled with tubes coming out all over and said, "I'm all better now." To everyone who helped out with the kids, prayed, and lent your support, thank you. I, one night in particular, felt your prayers and knew they had made a difference, and I again thank you.

Home from the hospital

We are finally home. D is doing well. More details later.