Friday, September 26, 2008

right with the universe

i got to hold and nurse my baby boy today! YEAH!!! : )

rowan was extubated this morning around 9 am, and by 12:30 pm he was in my arms, nursing just as he has since moments after he was born, eyelids gently sliding closed in ecstasy.

josh slept here with him again last night, and wesley, my stepdad, and i went to chick-fil-a for breakfast at 7:15 am, got here to the hospital at 7:45 am. we went back to see him, and he was quite awake and alert, and coughing on his tube a bit. he clearly wanted it out! his nurse, ashley, let us know she was preparing him for extubation, but hadn't heard from his doctors yet. i partially braced myself for another negative chest x-ray report and another 24-hr delay, but... minutes after the nurse left us, the doctor on shift, dr. sandell (i love her!), came in and said not only would the ENT be around in about 5 mins to perform the extubation, but rowan's chest x-ray showed so much improvement from the night before that they were going to extubate him at his bedside in the PICU instead of taking him to the OR! i was sooooo indescribably relieved, excited, and nervous. next, the ENT, dr. hung, came in, and he and the nurses stood around the bed moving things around and checking different tubes, drips, etc. then, before i could get too nervous about what i was about to witness, the tube was out and rowan was coughing and gagging... and breathing, perfectly, strongly. his little voice was hoarse, just like they warned me it would be, but it wasn't as bad as i'd imagined. josh and i stood on either side of his bed and touched him, stroked his hair and arms, spoke softly to him. he calmed down quickly at our touch and the sound of our voices. i thought i was going to have to ask the nurses to tie my hands behind my back to keep me from grabbing him. it's so involuntary!

so we just spent time with rowan in his room, by his bed, until 12:30 pm when his nurse came in and handed him to me. the feel of his skin on mine was like a deep, cleansing breath after being underwater for too long, or a burst of sunshine on my face after sitting in shadows. it was awkward, cuddling him around the tubes and electrodes, being careful not to tug on his IV or the little oxygen prongs in his nostrils. he's been disconnected from more and more devices as the day has progressed; by 4 am the sedatives and pain meds were gone, at 9 am the breathing tube came out, at 5 pm the oxygen prongs came off, and by 6 or 7 pm the IV fluids and lipids were disconnected. now he is just getting antibiotics and steroids, breathing treatments and CPT every 4 hours, and the little electrodes are still stuck to his chest, of course, monitoring his heart rate, his oxygen saturation level, his blood pressure, and his respiratory rate.

in the first hours after he was extubated, he would cry and tremble when an unfamiliar person would enter the room, because he knew a pinch or a poke or the sting of medicine going into the IV line in his foot was soon to come. he also cried through the first couple of breathing treatments and CPT sessions. but this evening, he is much calmer, much more himself, which is so nice and comforting for me. he fell asleep during the most recent CPT session. : )

now it's late - or early - and i'm here at the hospital with rowan, by myself. josh is at home with micah. she spent today with my sister-in-law, melanie, and mel said she "wasn't herself." i guess that means this deviation from our normal routine is starting to get to her. i hope she is okay tonight, if she wakes up and i'm not there... i miss her.

i just had a strawberry-peach-banana frullati smoothie and a blueberry muffin. my tummy and my heart are happy!

Thursday, September 25, 2008

little things

i am so touched by the attention to detail the nurses are giving to rowan here in the PICU. they are so tender, when they come in to wipe his eyes and nose, and moisten his lips and apply a little balm so they don't get too chapped. massaging his little wrists and hands, and rubbing his feet. things i would do for him at home. things i can't do right now, because i can't touch him.

i did find out a little while ago that one of the medicines they give him to keep him still (so he can't dislodge his breathing tube, and so he's unaware) is a paralytic. that freaks me out. how does the drug know which muscles to paralyze and which ones to leave alone?! i can't remember the name of the drug... i want to get a list of all the drugs he is on so i can look them all up, find out all i can about them. i don't know why, don't know what it will change... through this whole ordeal, i've found i'm much calmer if i know every little, minute detail of what the nurses are doing or administering, and what the doctors are ordering and why. i'm asking lots and lots... and lots of questions. and apologizing for it, which always gets a firm "don't apologize, ask as many questions as you want!" from the nurses. they're all so nice and personable. i especially appreciate the ones who take the initiative to tell me what they're doing before i ask.

the first night, i was jumping out of my skin every time one of the machines rowan is hooked up to would beep or click, or anything. now i've learned what the different sounds mean, and what all the numbers and stats and graphs on his monitors mean. i know what the respiratory therapists mean when they talk about his tidal volume, or his blood gas levels. i know how to tell by looking at the monitors how much of a leak rowan has around his breathing tube (meaning, how much the swelling in his windpipe has gone down). knowing all these little details calms me, makes me feel a little bit more in control.

i can't wait to pick my baby up out of that bed...


well, this is my first blog post... it has been a whirlwind couple of weeks. i did not really expect to begin my blog on such a serious note.

joshua, my husband, returned from a 4-week-long business trip to quitaque, tx a week and a half ago. two days after he got back, we were rear-ended at a stop light and our car was totaled. :-/ no one was hurt, thankfully, and we have enough insurance money to buy a used station wagon from a family member... so, everything really worked out the best way that it could!

now, 10 days later i am typing this from the waiting room outside the pediatric intensive care unit at medical city childrens hospital, in dallas. my almost-1-year-old son, rowan (his birthday is 10/5), was admitted here this past monday, 9/22, with a bacterial infection in his windpipe that was causing his windpipe to swell and close. he was intubated and put under heavy sedation, and moved to a private room in the PICU. it all happened a little fast... i took him to our family doctor early monday afternoon because he had been sick since wednesday with a fever and congestion. by sunday night his breathing was so labored and his chest was retracting (caving in) with every breath. he sounded like he was breathing through a straw. at his appointment monday, the doctor took one look at his chest and told me to go to the ER. this really took me off guard; i was expecting a shot, a breathing treatment maybe, and then on our way home, maybe pick up a prescription on the way for him, and then get home and fix something to eat. suddenly i found myself on my first trip to the ER, with my three-year-old daughter, micah in tow. my stepfather, wesley, met me at the pediatric ER at medical city dallas, and he was able to help with micah, and help keep me calm as well (he is a paramedic and very familiar with the goings-on of an emergency room, hospital, etc.). he also helped me not make a critical mistake of not letting the triage nurse in the ER know exactly how serious my situation was. in my heart i was wanting and needing the situation to be less serious, so i kind of strolled up to the triage window and calmly said, "uh, you know, my son is having a little bit of trouble breathing." smile, nod. wesley stuck his head over my shoulder and said, "her family doctor just saw her little boy and told her to bring him straight to you guys." that kind of changed her energy. she got us into a holding room and started rowan on breathing treatments right away, which he responded to temporarily, but the doctors knew something else was going on, something we couldn't see.

ahhh, this is so much detail, i appreciate anyone who has read this far...

after a bunch of bustling around and different doctors and nurses rushing in and out of our little ER holding room, rowan was moved to the OR for his intubation (insertion of his breathing tube). i got to hold him in the hospital bed as they wheeled us down the hall. he was so tired from working so hard to breathe, his little body just relaxed against mine. when we got inside the OR, i continued to hold him close as one of the ear, nose and throat doctors held a mask delivering sedation over his face. he struggled a little, but quickly fell asleep, and the doctors lifted him out of my arms. i wriggled out from under all the IVs and sensors that were already attached to him, and a nurse led me, trembling and feeling rather numb, back to the waiting room. the breathing tube was inserted with "mild difficulty" (i saw this on his chart later). my dad and josh's dad came to the hospital and sat with us while we waited to hear how the intubation procedure had gone. about an hour and 15 mins later, josh and i were able to join him in his private room in the PICU. he has been here since then, in and out of wakefullness but mostly deeply asleep.

two ENTs (ear, nose, and throat doctors) were on duty Monday, when we were admitted. one of them, rowan's attending doctor, dr. timothy trone, specializes in pediatric airways. the other one, whose name i didn't catch, had just returned from delivering a lecture on pediatric airway emergencies. i feel overwhelmed with the sense that we came to this hospital for a reason, that i was led here, brought here to those two doctors, who had all the expertise, knowledge, experience, and passion to quickly recognize my son's critical condition, act accordingly to capture his airway, and save his life.

i cried in the ER when there seemed to be a lot of nervous, urgent energy surrounding rowan and i began for the first time to fear for his life. i cried last night, when the nurse was working on getting some more sedative in his IV line and he was pulling against his restraints and his heart rate was rising, and i leaned in close and sang a familiar song in his ear. it is very difficult to sing and cry at the same time. and i cried a couple of hours ago, when another one of rowan's attending doctors, dr. matsen, took josh and i to see rowan's chest x-rays. rowan's extubation (the removal of his breathing tube) was scheduled for early this morning, but his x-ray showed that his left lung was slightly diminished and has some fluid in it (all very commonplace for someone on a ventilator), so his doctors decided to give him another 24 hours of breathing treatments and CPT (chest percussion therapy) before they extubate. my heart was so light all last night and early this morning with the hope that i would be holding him in my arms today, and the disappointment briefly overwhelmed me. but after a good, hard cry in my husband's strong, comforting embrace, i felt peaceful and happy again. rowan's lung will be in wonderful shape tomorrow morning. he has no signs of pneumonia, and his infection is showing all the signs of disappearing. dr. matsen is happy with his progress, and told us that in all likelihood if they took the tube out today, rowan would cough a bit and his left lung would pop out and be fine... but just to be on the safe side, we will wait. i am so thankful for dr. matsen and dr. trone, for their expertise and diligence.

oh my gosh, this is so long... all my posts will not be this long, i guarantee. i created my blog a couple of days ago, and so much has happened that i haven't had time to post regularly. so i'm squeezing it all in here. thanks, again, to anyone who's read it this far. : )

here is rowan on the 2nd or 3rd day, with his breathing tube in...

and here's me holding him a couple of hours after the tube came out...

and here he is the day we were discharged, all better! : ) this is my favorite one to look at.