The details

So yesterday was a gradual transformation from a runny, crusty, I have a cold, baby to one who was coughing so hard and so often that his face is broken out all over with petechiae. He went from runny and drippy to a thick goey paste that he was choking on. In the early evening he had a coughing fit that lasted so long he could not catch his breath and turned purple (really purple) and desatted down to 79. I paged his pulmonologist and ran around throwing a bag together. Mike did not think he was stable enough to drive so I was going to call an ambulance once the Dr. told me what hospital to take him to.
When she called back she said that she had called his pediatrician and discussed everything with him and that they both wanted Tomas to go to his childrens hospital. That is about an hour drive. But the pulminologist was still in her office so she wanted me to bring him there first to make sure he was stable enough to drive to the hospital.
While I was waiting for the Dr. to call  back my husband squirted Afrin up Tomas' nose. I didn't think it was a good idea because it was made for adults and also he aspirates everything liquid and who the heck knows what would happen if you get afrin in your lungs. It did make a difference though; he stopped coughing and gagging and choking and just about instantly fell asleep.
When Tomas and I got to the Dr. office (Mike stayed home with the girls), Tomas was pretty settled down and I thought "Great, she is never going to believe how bad it was!"  But he was retracting and nostril flaring and head bobbing and doing all the stuff he always done when he is working too hard to breathe, and then came up positive for the RSV swab. She said he is wheezing and he wasn't the day before when she did her initial exam. So here was the choice she gave me. We can put him in the hospital, because RSV peaks between  day 3 and 5 (and yesterday was day 2) or we can try to keep him home but I would have to work around the clock with meds and breathing treatments to keep him from getting worse.
Honestly, I was so tired I was ready to go to the hospital, plus when he shuts his airway down during those choking spells it scares the daylights out of me - he has always done that, and I don't know if any of you have ever held your baby when he is purple and limp but it is downright awful. I told her all this and she said she agreed except for one thing - his neutropenia. We all know hospitals are germ factories, and she told me it really should be the last place he should be right now because RSV makes the mucosa so pastey and thick that bacteria gets trapped there, and with his ANC down he would have a hard time fighting off anything he was exposed to. Great, guilt!. Well of course I'll keep him home. So she called in a bunch of meds to the 24 hour pharmacy (it was around 9:30 by then - have I mentioned she is an AWESOME Dr.) and we were home by 11. It was a very long night but Mike was just as involved as I was so each of us got a little bit of solid sleep. Tomas is stable this morning and has not had any moreof those huge coughing spells. He is still breathing pretty hard and a nasal disaster, so we will keep working even harder and hopefully it will work!