911 Nosebleed

I can't believe how long it's been since I've done an update about Tyson!  The month of June just flies by, doesn't it?

Since the last time you checked in, Tyson had just been released from the hospital from his pneumonia.  He came home on a Monday, had a few days of rest at home, and then was ready for to school again by Thursday.  On his very first day back to school, he suffered a nose bleed.  It started slow at first; the teacher called me and I hurried over but by the time I got there, it had stopped.  An hour later it started up again and this time he bled so bad that he was swallowing large amounts of blood (as much as we tried to keep his head tilted forward) and he then began throwing up blood.  After an hour and fifteen minutes without slowing down in the least, we had to call 911 to have an ambulance escort us to the hospital Emergency Room.  With Tyson having just recovered from pneumonia and being hospitalized, I was concerned that a nosebleed of that nature would cause his hemoglobin level to be too low, in which case he’s need a blood transfusion.   I was also concerned about the amount of blood that he was throwing up.  It always looks like more than it really is, but still - who likes to see their five year old throwing up blood?  Thoughts were running through my mind like crazy, "I have to get this kid to the hospital, this is going on way too long.  I can't drive to the hospital and hold onto his nose at the same time.  Do I get a school staff member to drive us to the hospital or do I call 911?"  I'm so thankful that I listened to my gut in calling 911, because as soon as we were settled into the ambulance, Tyson began throwing up even larger amounts of blood.  He was crying and panicking, I was emotional at the sight of so much blood coming out of my little five year old, and the paramedics were faithful in keeping us both calm. 

Once Tyson was seen by an ER Dr, they did some blood work to check out his levels.  The Dr couldn’t do much to stop the bleeding since his nose is too small to be packed and she was afraid it would do more harm than good.  Blood work was done, his hemoglobin level was normal, and his INR level was actually a little on the low side for him.  (1.5) Surprising, considering such a bad bleed, we'd expect his INR level to be way too high - like 3 or 4.  The ER Dr said the bleed was likely due to the dry hospital air during his last hospital stay, and not having the saline spray, Vaseline, and humidifier routine that we normally have at home.  The bleeding finally stopped at 5:00pm that afternoon (it started at 1:30pm – not including the small nosebleed an hour earlier at 12:30pm)  The ER Dr sent us home and referred Tyson to an ENT for follow-up, since he tends to get frequent nosebleeds.

It was quite a traumatic month for Tyson.  Within a matter of three weeks, he experienced a teacher change in Kindergarten (which always takes some adjustment,) then a hospital stay for pneumonia, and then a nosebleed that sent him to the hospital by ambulance.  For a few weeks after those incidents, he became very clingy and didn’t want to leave my side for even a second.  If I was ever more than a few steps away from him he would cry hysterically. I felt guilty for leaving the occasional evening to go to Bible study or meet up with friends because I knew Tyson would be uneasy.  Even if we tucked him into bed first so he wouldn’t know that I was leaving, he would come out of bed several times asking me if I was staying home.  He became so uncertain and so mistrusting of anybody else but his mother, that I had to lie to him if I wanted to go out anywhere.  He even started to get a little delusional about things that might happen to me while I'm gone, or things that might have happened to his siblings if their school bus was a little late coming home.  I am thankful that it was just a passing phase, because I was beginning to get concerned about having to take him to see someone about his anxiety.  He also hasn't had a single nosebleed since the 911 incident. Maybe that has helped and could be why he has gotten better with me leaving him for a while.

A week after the 911 nose bleed, we saw a local ENT who looked up Tyson’s nose with a special light and said that there are 5 or 6 vessels on each side of his nose that will need to be cauterized.  He could see the one that had caused the last nosebleed and he said it was quite large and would need to be done as soon as possible, because any little thing could set it off again and we’d be in the same position as last time with having to go to the hospital.  However, because there are quite a few on each side (and both sides can’t be cauterized at the same time) he said he’d need Tyson to stay still for several seconds while he burned off the vessels…I assured him Tyson would not sit still for a procedure like that and it would not be a pleasant experience for anybody involved.  The ENT then recommended that Tyson be sedated for the procedure, but with Tyson’s complex cardiac history the anesthetists in Orangeville wouldn’t be comfortable with it so it’s off to Sick Kids we go for that too.  Dr Riddell put in a referral to an ENT at Sick Kids and we’ll wait to hear from them. 

That’s all for now.

Melissa