Since he was less than a year old, when Ben got a bad respiratory illness, it usually manifested as croup.
I'm not sure how many times he had it, but I know it was often enough that whenever Chris and I were awakened by the familiar seal bark cough, we could spring into SWAT team-like action without exchanging many words.
One of us would gather Ben up in a blanket and bring him outside in the cool, damp night air. The other would fling open the doors and windows in the house, start the humidifier, and get a popsicle out of the freezer.
Other times - fairly frequently actually - Ben would just wake up with a garden variety cough and we would blame it on dry air caused by leaving the thermostat too high by mistake. We'd open his bedroom window and wait for it to subside.
The doctor even gave us an albuterol inhaler two years ago during a really bad cold when his cough included wheezing.
But no one ever called it asthma.
Until last weekend, that is.
Ben was sent home from school on Friday with a bad cough. When it didn't get better at home, we tried the inhaler but it seemed empty. I called to get a refill, but the prescription was two years old, and the doctor's office wanted to see Ben before a issuing a refill.
Our plan was to bring him in to the urgent care clinic the next morning.
A couple of hours later, Ben couldn't finish a sentence without wheezing, and with the blessing of the on-call nurse, we headed for the emergency room.
At this point, Ben was cheerful and energetic. He ran and skipped into the emergency room, singing along the way, and goofed around in front of the closed-circuit video monitor. I was expecting we'd get an inhaler and be home in an hour.
The triage nurse examined him and typed "Respiratory Distress" into her computer. The respiratory specialist was incredulous that we hadn't brought him in sooner, given the severity of his asthma.
Asthma? Did I mention he was skipping and singing?
After an hour of inhaling albuterol through a mask, the doctors still heard too much wheezing in his lungs. They wanted to admit us for the night.
I convinced Ben we were going to have an adventure in the hospital and that I would stay with him. He wasn't happy about it, but he stayed mostly calm, given that he had three wires stuck to his chest, a mask and a monitor strapped to his finger.
The really hard part came when we had to tell him he had to stay a second night.
I think Ben was stable and healthy enough to go home, but I get why they were so cautious. Especially if you consider that many families who come to Children's Hospital in Oakland don't have a primary care pediatrician. For some, this is the sole touchpoint to ensure that the family understands and will stick to the "Asthma Action Plan" that will keep the child from coming back.
A nurse sat down with us to make sure we understood what to do: yellow zone, red zone, two puffs, peak flow, identifying the triggers, long-term controllers and quick relievers.
We have a plan, and drugs, and we know what to do now to keep this from happening again, just like 1 out of 6 families in Oakland who have also a child with asthma.
Ben is home, healthy and doing just fine.
Mostly, I'm heartened that he was able to make it through an experience that was a sensory nightmare, that kept him from nearly every important ritual in his life, and one in which he faced nearly constant, difficult limits (like being confined to his bed for two and a half days).
He fussed, sulked, cried, and screamed bloody murder at us several times, but he also happily watched videos on a portable DVD player, read books, and played with the up-down controls on his hospital bed over and over again.
(Can I just tell you how much he loved the bed?)
If you would have told me last week, "Ben is going to have to go to the hospital on Friday night and stay for a couple days," I would have suffered a major anxiety attack.
But, surprise: there we were. And we did okay. He is capable of quite a lot. More than I ever would have expected.
Do you think I'm spoooooooky? (Ben mugs for the camera in the ER)