Abraham, Rachel, Soren and Liam. Our life together in Smalltown, Idaho.

Sunday, May 24, 2009

Liam's Medical Saga, III

Primary Children's is sending a fixed-wing airplane to pick up Liam. One parent, they tell us, is allowed to accompany the patient. The other one will have to drive. Abe goes home to gather up a few more things and start the drive to Salt Lake. He insists that he can drive alone. As he leaves, I ask, "Are you sure you don't want me to call Marty? Or Nick? They could ride with you and keep you awake." "No, no, I'll be fine," insists Abraham. As soon as he is out of the room, the slightly neurotic alpaca-loving RT looks up from torturing my infant with her deep nasal suctioning and says, "Call Nick. Or Marty. Also, maybe they'll let you breastfeed on the airplane."

The next few hours I spend puttering around, gathering up our belongings, eating, pumping, making phone calls, sending text messages. I call my sister, awakening her out of a deep sleep, and ask if she could spare her husband for a ride up to Salt Lake. "Um, um," she says, and I can almost see her shaking her head and trying to pull off the cobwebs. "Um. I'm so tired. Hold on. Um, I think Marty has to go to work in the morning." I feel like a louse for waking her up and making such a hearty demand. Tears fill the back of my eyes. "Right," I say. "Duh. Sorry. Love you." I hang up.

My text message awakens Loriann, who immediately calls to tell me that she loves us and is praying for us.

Abe calls later to tell me that Marty is riding with him to Salt Lake.

I keep dipping the pacifier in sugar water and plugging it into the baby's mouth.

1:00 AM
Three people comprise the Life Flight team: Lisa, an efficient young woman with kind brown eyes and black buns on the sides of her head, Dave the pilot, and a sleepy-looking blond woman whose name I immediately forget. Two members of the Idaho Falls Fire Department are there to man the ambulance that will take us to the airport. The younger one tells me that his little girl spent some time at Primary Children's Hospital last year. "They are very good there," he says.

Dr. Hatch is still watching over the process. He looks exhausted. I shake his hand as the the team loads Liam into an incubator and start rolling him in a gurney toward the exit. I say, "Thank you so much for everything." What I want to say is, "You are a good egg."

1:15 AM
The fireman who drives the ambulance is in his forties. "Those kids," he says, "They're nothing if not a source of worry." He tells me he has two daughters, ages sixteen and nineteen. The older one just recently moved out, got a job, her own place. We talk about the weather. Isn't it crazy, how it can be snowy one minute and sunny the next? "If you don't like the weather in Idaho," he says, "Just wait a minute and it'll change." I laugh like I've never heard that one before. We drive along in silence and I imagine that he drinks coffee out of a thermos and votes a straight Republican ticket. I wish I were five and could sit in his lap.

1:30 AM
The airport is windy and Dave lets me wear his Life Flight jacket. He gives me the mandatory pre-flight emergency exit/under-seat flotation device/oxygen mask/safety belt lecture. Liam's gurney is loaded onto the plane.

1:45 AM
Take-off. I am surprised at how many lights are on in Idaho Falls at this hour. It is beautiful. I try to enjoy the flight, as I imagine it is costing me one thousand dollars a minute.

2:00 AM
Liam is screaming and I can't even touch him. I see him in his incubator, attached to tubes and hoses, flailing his little arms around and screaming so hard his face has gotten splotchy. I pray. "Dear God, he is so little. He doesn't understand any of this. I can't comfort him right now. I can't do anything for him right now. Will you please send someone to comfort him for me? Please, Father, you know I don't ask anything for myself. All I want is for you to spare an angel, perhaps, someone you don't really need, for just a few moments to come comfort him. Please, Father, please. He is so little. He is so innocent. Please." I beg and plead for several more minutes. Then I wait. Nothing changes. Liam continues to scream, continues to flail. This is the first time I've prayed since Liam got sick. It is also the last.

2:30 AM
Lisa looks up at me and shouts over the noise of the plane, "It must be so hard for you to see him so hungry and not be able to do anything!" I nod. "I'm sorry!" she says. The blond lady has fallen asleep.

3:00 AM
Salt Lake. The ambulance driver who takes us from the airport to the hospital is a darling man whose accent reminds me of Brad Pitt's in Seven Years in Tibet. From this I conclude that he is Austrian. "What is up with the little pumpkin?" he asks, jerking his head toward the back of the truck, and I love him instantly. I love him even more when he says, "Do not be alarmed if I run some red lights. At this time of night, I'm not going to sit at a light where there isn't any traffic." He, like the first ambulance driver, also has two daughters, though his are little: four and six months. He tells me that they taught their older daughter ASL to help assuage the terribleness of her twos. We drive down an empty street lined with trees and old Victorian houses.

3:20 AM
I don't remember how we got to the PICU. I remember getting out of the ambulance and handing over the Life Flight jacket; next I remember standing next to my baby while a team of medical personnel hover over him, giving him a new IV, poking his heel yet again, trading his little nasal cannula for the bulkier CPAP, which is attached to hoses instead of tubes. A girl in a brown ponytail shakes my hand. "I'm Dr. So-and-So," she says. "I'll be taking care of William tonight." I wonder if she's over twenty. The crib next to ours is occupied by a nine-month-old who is also attached to oxygen and IVs. His Mom, who looks like she's about my age, is bowed over in a rocking chair next to him, fast asleep. I am sorry we are making such a ruckus.

3:30 AM
It's all I can do to keep from ripping the head off the next person who comes in to draw yet another blood sample from my six-week-old's heel. I want to scream at her: "There is NO BLOOD LEFT! He only weights twelve pounds! Leave him the hell alone!"

3:40 AM
Abe arrives. I am grateful he is there to hold me.

4:00 AM
Liam's respiratory rate has dropped from 80-90 to 60-70. His chest retractions have been reduced considerably. His blood glucose levels are up. Abe falls asleep on the chair/bed next to his crib.

Sunday, May 17, 2009

Liam's Medical Saga, Part II

11:00 AM
Abe returns from dropping Soren off at Grandma’s house. Someone brings us boxed lunches. I nurse Liam for what ends up being the last time in five days. The nurse says his oxygen saturation level will probably go down while I feed him. Instead, it goes up.

11:30 AM
Liam and I take a ride on a gurney. I try to enjoy the fact that I’m being wheeled down the hall of a hospital while fully conscious, but I mostly feel self-conscious, as everyone who passes tries not to stare.

11:35 AM
We are given a room in the pediatrics unit and I answer the same questions I answered first at the doctor’s office, then multiple times in the ER. Liam trades in his oxygen mask for a nasal cannula. We are assigned a nurse, Micky, and a respiratory therapist, Heidi. Everyone keeps commenting on how hard Liam is working to breathe.

For the rest of the day, Micky comes in at least every hour to check Liam’s breathing and oxygen saturation levels. People come in periodically to draw blood from his heel. Every two hours, Heidi pounds on Liam’s back with a little stick called a percussor for several minutes, which he loves, then does a “deep suctioning” of his nasal cavity, which he hates.

Dr. Baker, our family practitioner, shows up. I am relieved to see him. Not only do I have a mild crush on the man, I trust his opinion and know from past experience that he won’t recommend any unnecessary interventions for my baby. He looks at Liam, listens to his lungs, then says: “He’s doing okay right now, but I’m wondering how long he’ll be able to sustain this sort of effort. If he gives out, this is not the place to do it. I’m thinking he’ll need to be transferred to Primary Children’s.”

We are then introduced to the pediatrician on call, Dr. Hatch, who stays at the hospital with us, keeping a close eye on Liam, for the rest of the time we’re at EIRMC. He puts Liam on three different antibiotics, “just in case” the infection causing all this is bacterial. Dr. Hatch wants to put the baby on CPAP (Continuous Positive Airway Pressure) but is told that at EIRMC only preemies can be put on CPAP.

The rest of the day is spent holding Liam’s hand (and stroking the tiny patch of head not covered by a bandage) while he is poked, prodded, pounded, listened to, observed, suctioned, and given albuterol treatments. Abe and I learn about respiratory rates and pass the time counting his breaths per minute. When this gets boring we try to remember all the states and their capitals.

4:00 PM
I am so full of milk I can’t bend over. I beg for, and am given, a breast pump kit. The medical staff says I am not allowed to nurse the baby because he’s working hard enough just to breathe; eating would just be too hard for him right now. They are also afraid he might aspirate, which would exacerbate his pneumonia. I think this might be a bunch of hogwash, remembering our experience in the emergency room, but it might not. I don’t want to risk it. I wish I had a medical degree.

4:30 PM
My mom leaves Soren with Grandpa and drops by for a quick check-in.

6:00 PM
Collette and Marty stop in for a visit.

7:00 PM
Liam’s blood gas reading shows surprisingly healthy levels of oxygen and carbon dioxide. The doctor thinks we might not have to transfer him after all.

8:00 PM
I send Abe home to get some toiletries and pajamas so that I can spend the night with Liam in the hospital.

8:15 PM
I don’t want to be alone while Abe is gone, so Nicholas comes over to sit with us for a while. He brings a deck of cards, a DVD, and a pile of reading. He holds up books: Mother Theresa: Come Be My Light, “or, if you want something lighter,” The National Geographic “or, if you want something even lighter,” Elle D├ęcor. We talk politics and giggle.

9:00 PM
Liam is ravenous. He tries to vigorously suckle anything that comes near his mouth. The nurse brings in a magical substance called “Sweet-Ease” (basically: sugar water). I dip his pacifier in the sugar water and give it to him. He sucks it off quickly, spits out the pacifier, and screams for more. I spend much of the rest of the evening making sure he has enough sweets.

9:30 PM
Abe comes back.

10:00 PM
We are assigned a new respiratory therapist. She has wild hair and even wilder eyes. She slaps the percussor haphazardly around Liam’s back. Every time we are alone in the room, she looks around conspiratorially and says things like, “I’m not supposed to say anything, but I think you should nurse him.” “The doctor won’t let you breastfeed because he’s a man and doesn’t understand anything.” “I think you should just close the door and nurse the baby.” She tells me about her Alpaca cooperative. We talk knitting.

11:00 PM
A blood gas reading shows that Liam’s CO2 levels are increasing. This is a bad sign, according to Dr. Hatch, who says that it indicates that his respirations aren’t doing their job as efficiently as they should. “He may go into respiratory failure and need to be intubated,” he told us. “And if he does, it would be better for that to happen at Primary Children’s so we wouldn’t have to transfer him while intubated. I’ll call in the emergency response team. They should be here in about two hours.”

Thursday, May 14, 2009

Liam's Medical Saga, Part I

There's so much to say about this little medical adventure we've been having that I think I'm going to start posting about it in themed installments. I'll start out by describing how we got here and what they've been doing to our boy. Then, over the next several posts, I'll fill in the details as I see fit.

April 6 - April 14 . Soren gets sick. He's got a nasty cough and a runny nose. He sleep a lot. He wants to be held all the time. I spend a lot of time with Soren balled up in one arm while I hold Liam in the other. Soren coughs all over everyone. Abe also gets sick and takes a few days off work.

April 12 - April 13 . Liam starts coughing. It's just a little cough, though, and everything else seems fine, so I don't worry about it.

April 14.

Night time. Liam's starting breathing a little faster and seems uncomfortable. During the night, after his feedings, Abe cuddles the baby and keeps an eye on his breathing. We decide something might be wrong. I have to get a physical done in the morning for my job, so I decide to bring Liam along with me and have the doctor take a look at him. My appointment is scheduled with Dr. James Brook, a rogue doctor who has decided that healthcare these days is going in the wrong direction. He has taken a step back, working to offer "modern medical care with old-time service." He's not our family's usual doc, but Harbor House (my place of employment) likes to work with him.

April 15

8:00 AM. Liam seems considerably better in the morning, and I almost feel silly bringing him to the appointment with me. I decide to do it anyway. Dr. Brook completes my physical, declares me whole, and then looks at the baby. After some assessing, he says, "It looks like he's got bronchialitis. Let me prescribe him a steroid (prednisolone) to help open his airways. Keep an eye on his breathing and give me a call--even in the middle of the night-- if it seems bad." I am proud to note that he weighs 12 pounds, 15 ounces—a weight gain of almost 6 pounds since birth.

9:00 AM. I take Liam to work with me, but he's so fussy I can't get anything done. We leave after an hour. My mom watches the boys for me while I take a nap.

6:00 PM. Documentary night! I make Chicken Tortilla soup. It's delicious.

7:00 PM. Liam seems worse. He’s very pale. I wonder if his lips are looking a little purple. Abe and I are unsure whether we should call the doctor or if we're just being Nervous Nelly parents. Nick mentions— not to freak us out or anything—that a baby in Idaho Falls recently died of Whooping Cough. I google Bertessis to see if Liam's symptoms match. They don't. We call our home teacher, Brady Cook, who comes over and assists Abe in giving Liam a priesthood blessing. Abe cries. We both feel better and go to bed shortly thereafter.

9:00 PM. Liam sleeps in the crook of Abe’s arm so that he can keep an eye on him. It’s a rough night. Liam’s breathing hard and blowing bubbles. Abe tells me that at one point in the night, Liam looked up at him with big sad eyes as if to say, “What’s happening, Daddy?” He’s still nursing, though, which we take to be a good sign.

April 16

7:00 AM. My baby looks like a corpse. He is very pale, his lips and fingernails are purple, and his eyes are dark and unresponsive. I feed Soren breakfast and call the doctor. He rearranges his schedule to see us immediately. I load up both the children and drive to Idaho Falls. My mind is hazy and I get lost on the way to the doctor’s office. I have to call to get directions even though I was there just yesterday.

8:30 AM. Dr. Brook listens to Liam’s breathing, takes his blood oxygen saturation levels (they’re at 80%-- they should be well over 90%), gives him a dose of Albuterol, and tells me my baby needs to be in the hospital on oxygen. “Take him to the emergency room,” he instructs. Soren has taken out every single toy in the office and scattered pieces everywhere. I frantically try to pick everything up, encouraging him to help (he doesn’t). A lady in the waiting room watches without expression. The doctor asks if I’m new in the area: do I need directions to the hospital? I tell him I’m not and that I should be able to find it. “Just turn right on Holmes,” he says, “Then left on 17th. That will take you to Channing Way. It’s a big brown building. You can't miss it.”

9:00 AM. I call Abe and tell him we’re going to the Emergency Room. He knows immediately (but does not say) that we will end up at Primary Children’s Medical Center. I think we’ll just be in the ER for a few hours, fueling up on oxygen, and then will be on our merry way.

9:15 AM. Liam is surrounded by people in the Emergency Room. He is lying on an adult-sized hospital bed. They hook him up to monitors, hold an oxygen mask over his face for oxygen, take a blood sample from his heel. Someone comes in and takes x-rays. A respiratory therapist shoves a suctioning tube up each nostril and deep into his nasal cavity. A crowd of women poke him in multiple places and finally get an IV inserted in his head, which they wrap with gauze, making him look like he’s got a serious head injury. I quickly learn how to read the monitor that measures his oxygen levels and heart rate. Soren keeps screaming that he wants to play with toys. I dig through my purse and find a little bag of conversation hearts, which I give to him on the condition that he sit on a chair in the corner while he’s eating them. He sits on the chair and eats his candy. He looks very small. Daddy shows up, squeezes Liam’s little hand, and takes Soren into the waiting room.

9:30 AM. Soren pulls his penis out of his diaper and pees all over Abraham.

9:45 AM. Dr. Wells—the young ER doc taking care of my baby—shows me the x-ray of Liam’s lungs. He’s got bilateral pneumonia that has collapsed half of one lung. “This is the worst case of pneumonia I’ve seen all winter,” he tells me. “And it’s April. We’re going to admit him.” I nod, still thinking we’ll somehow be done with all this by evening.

Sunday, May 03, 2009

Home Again

On April 28, after 13 days in the hospital, we were finally able to come home. Liam spent two more days on oxygen and is now back to his happy self. I'm working on the saga and will post it in installments soon.


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