The Lung Ward - Part 1

When we stepped off the plane last Thursday, we didn't think of anything bad.  The sun shone brightly, we got through immigration and customs in a breeze, and Doug had brought chocolate and water to the airport.  We were finally all back together again.  It was all good.

Two hours later, Alan complained of a splitting headache.  When I touched him, he felt burning hot.  I took his temperature - it was a shocking 40.1 C (104F).  I gave him some ibuprofen and sent him to bed.  Uncharacteristically, he fell asleep and slept until Doug came home from work, briefly woke, drank a cup of water, and went back to sleep.  Whenever I checked on him, he was asleep, although he kept claiming that he couldn't ever really sleep, he just dozed.  Well, then he dozed a lot.  The fever kept coming and going and it was usually so high that I totally misjudged that he had a continuous fever, because the low grade fever episodes were so cool compared to the really hot epsiodes.  Friday went by in a blur, then it was the weekend.  There was other stuff going on - mold in Alan's closet, the heating had stopped altogether, I had repairmen in and out all the time, and the landlady on the phone.  I had the impression he was getting a bit better and even entertained the thought of sending him to school on Tuesday - Monday was a holiday.

But I noticed his breathing was fast and shallow, and that his pulse was very high.  More ibuprofen.  I thought it was the fever. Kids get sick, right? But something was off.  I tend not to trust my intuition but maybe I should.  It was Sunday, I think, when I said to Doug, "His symptoms are congruent with pneumonia." 
"But he doesn't cough at all!"
"He coughs a bit, he's been coughing for a while now.  And he's got diarrhea, fast breathing, high fever, headaches, the works."
"I can't imagine that.  Shouldn't he be sicker with pneumonia?"
"I know.  It's probably just a virus he got from that awful woman who coughed on us on the transfer bus at the airport."

But on Monday, I finally called our pediatrician.  It just didn't seem right.  The doctor didn't have time that day, and they gave me an appointment the next day, Tuesday, at 3 pm.  Tuesday morning had Alan perked up a bit.  I even sat him down to do some school work.  He wasn't particularly good at it.

So we went to the American Clinic at 3 pm, had to wait a bit, then the doctor came out, saw us sitting in front of his room, touched Alan, and turned to me and said sharply, "He has a fever!"

"Why, yes, that's why we are here.  But I don't think he's got a fever now, no?"
It was that thing about the very high fevers, and the low-grade fevers.  Alan had a temperature of 38.9 but it seemed cool to me, compared to the almost 41 degrees the fever would spike to sometimes.

The doctor turned to Alan, looked into his throat, and immediately sent us downstairs to the ER, ordering blood tests and urine tests as we went.  We never saw his examination room, it was very fast.  This was the moment it occurred to me that Alan might have more than just a nasty virus he caught on the plane.  Maybe, some little voice nagged in the back of my brain, maybe he does have pneumonia.

Downstairs, they drew blood and sampled urine, and then the doctor listened to his lungs.  He ordered an X-ray.  "Your son is very, very sick."  Six little words you never want to hear from anybody, especially not from a doctor.  Let me add here that Dr. Hasani may sometimes appear rather brusk to parents - but I believe it's because he loves kids and cares about them, and seeing them in pain distresses him.  He was angry at me for not coming in sooner (uh, no appointments?), and I was scared.  The X-ray done, he ordered a round of IV broad-spectrum antibiotics for Alan.  They needed to start shooting at whatever this was, he said to me.  He was going to see us back upstairs after the IV was done, to look at the X-ray.  "It's really bad," he said.   "What is it," I asked and knew the answer before he even said it, "Pneumonia."

Major parent fail.

I have to add that Alan himself seemed more annoyed than anything, and that kept me from falling apart:


"It's very, very bad," the doctor told us back upstairs in his room and showed us the X-ray. Right upper lobe pneumonia, and the rest of the lungs were already under way as well.   He told us to go to the University Hospital, to the Children's Clinic.  Only they were equipped to deal with this kind of sickness. 

I didn't question his advice.  Multiple times he told me, "Go there tonight, don't even think of going tomorrow, this cannot be treated at home!"  So we went there, with only a brief stop to get Alan something to eat and pack a few things for the hospital.  We were just out of a hospital, right? Alan's tonsillectomy in Germany was only a few weeks ago.  We could handle that, I thought.  At the last moment, I packed some water, and some small snacks.  An apple.  A bag of chips. 

Which was wise.

It was dark when we arrived.  The university hospital of Pristina is located on a big, partially wooded area with several buildings distributed all over the grounds.  It's confusing especially in the dark as it's not well lit at all, and the signs are not well thought out.  I asked someone and they said something about the Gynecological Hospital which made sense.  There was no parking anywhere, lots of honking cars, people crossing the road, narrow lanes cordoned off by traffic cones.  Chaos and confusion, is how it seemed to me.  We parked... somewhere.  Then we walked to the Gynecological building but that was a fail. 


It took a while to find, in the dark, without signs, someone who could point us to the right hospital.  It was tucked away behind an ultramodern building that turned out to be the Kosovo Transfusion Center.  We walked into the wrong door.  The guard pointed us to the right door around the corner. 

The Emergency Center of the Children's Hospital is friendly, clean, open - and comes directly from "the American People".  After some frantic discussion, the doctor explained to us that we really should be in the lung ward (that was the "wrong" door from above).  But the lung ward didn't have any beds tonight, so we were to stay in the ER over night and then be admitted to the lung ward in the morning.  I asked  if we should rather leave and come back in the morning but that was greeted with horror - no, we had to stay and start treatment right away, "Your son is very, very sick."

That's how Alan ended up in the ER, on an exam stretcher, hooked up to an IV all night.   And me, next to him on an identical, and equally uncomfortable stretcher.  The first thing you always get in a German hospital (right after you signed a plethora of agreements and waivers and contracts) is a bottle of water.  There was no water, but truth be told, there was no signing of anything, either.  Since this was the ER, I wasn't surprised that there was no water or meal service.  I was glad of the water I brought, and the apple, and the chips.

The night was long, and loud.  The nurses - my goodness, they were loud.  Albanian is not a language that seems to lend itself to whispering.  The doors swooshed open and closed all night, children wailed and screamed, parents discussed, door banged shut.  And whenever there was a lull in the activity outside, a nurse would rush into the room to check on Alan's IV.


We had a little sink in the room, and there was a toilet in the hall.  It had no lock, and no toilet paper. 

It was a harbinger of things to come.

During the night, I was on the phone and on FB messenger in contact with a new nurse friend in the US and my neurology doctor BFF, with relatives and friends all over the world.  I insisted on a check of Alan's oxygen levels on the advice of the new nurse friend.  I posted the Xray and the blood work to her to check it out.  I watched for signs she told me to watch for.  I was feeling not quite as helpless as I might have without all this awesome help.  Of course, I also got more and more scared, so much so that I made Doug contact our med-evac company to arrange for Alan's evacuation if he didn't get better fast.  His very high protein levels (166, 6 is normal) confused everybody, including the doctors in the ER.  I fretted over the fact that he wasn't hooked up to monitors at all.  I could not sleep.

It was a very scary, confusing, and restless night.