Discharge, Take Two

  

Andrew helping with a haircut a few months ago.

Soooo, we were supposed to go home yesterday.  (Notice the words “were” and “go”.). Didn’t quite happen.  We were so close.  We had discharge papers and everything.  And then Aaron decided he wasn’t quite done.  About 1:00, he dropped his sats, and then dropped them some more.  We ended up on 10-12 liters just to maintain 80%.  A rash followed.

Before his transfusion, I spoke with the doctor about what I needed to be watching for as far as reactions.  He told me that the vast majority were skin reactions, and that almost all adverse events would show up within 24 hours.  Um, we were 25 hours since the transfusion started, 23 since it ended, right smack dab in the middle of that magic 24 hours.

I called William and told him I wasn’t sure what to do.  He laughed and said he was pretty sure I did know, I just didn’t like it.  I sighed, he was right.

So we stuck around one more night.

I like to think I made a difference though.  Memorial Day weekend, just like any holiday weekend, is a big deal in an ICU.  There are a lot of traumas, and as I passed our attending in the hallway, she just looked beat down.  I could hear some of the drama she was dealing with, and it wasn’t even just trying to keep kids alive. (I know, some “just”, right?). There were parents who were attacking her decisions, challenging everything.  I know as parents we have to be our kids’ advocates.  But this was common sense things, like they didn’t like staff gowning up to go into their child’s room because it made the child anxious.  Um, your child has a virus (and I know, ‘cause I heard you yelling about it).  Your child is a danger to other kids.  Yeah, it’s “just a cold!”  But that “just a cold” has them in the PICU, and my child, too.  Frankly, it’s not “just a cold”.  Okay, off my soapbox.

Anyway, I had a chance to talk to her last night before she left and tell her I was so grateful for all her help.  I was also a parent who questioned and challenged some of her decisions this week.  She was so grateful for my thanks.  Ironic, she works so hard to keep these precious children alive and get them healthy again, and sees so much grief.  I think as parents, we need to be more conscious of the doctors and all the staff as people, people with hearts and feelings, and often children of their own.  Almost eight years ago she wrote in Aaron’s book about how happy she was to see him doing so much better after heart failure, and that he should go home and be happy and not come back.  Well, two out of three....

So here we go again.  They’ve pretty much just changed the dates on the discharge papers.  And we should get home just in time for big brother Andrew’s birthday.  Happy birthday, kiddo.  15 looks good on you.

If we are facing in the right direction, all we have to do is keep on walking. 

~Buddhist Saying

Trying to Increase the Baby Steps

Still here, still slow progress.  Today the team decided to go ahead and try a blood transfusion.  Yeah, we thought we were going to do that a few days ago, but no intervention is ever without risks, and they really wanted to see if he could recover on his own.

But yesterday there wasn’t much progress.  I mean, there was if you look at stability.  We didn’t have the wide swings in oxygen that we’ve had, but he also still needed the same amount, we weren’t able to break below 55%, and it was still usually 65-70% oxygen.

So today we added in more blood.  The thought is that if he’s got more “boxcars” (blood cells) to carry that oxygen around, his body will do better, because no matter how much oxygen you pump into someone, no blood cell can carry more than 100% oxygen.  So more cells means more oxygen.  At least we hope that’s the way his body will read it.  It worked several years ago.
  

And shortly we also hope to transition back to his home vent, when they get some time around here.  In spite of the “season” winding down, it’s still pretty busy in the unit.  Lots and lots of kids needing special care.

Aaron is in pretty good spirits.  We had about an hour last night where he was very upset, crying, which is not like him at all.  It was heartbreaking to hold him as he sobbed.  We don’t know why, maybe the steroids, maybe he’s just done being here.  But his happy smiles are back, and he’s spent the day watching movies on the TV, and scrunching his face and trying to see past anyone who blocks his view.  How like a kid is that?

All things working the way they’re supposed to, I’m hoping for home tomorrow.  I’d really like to exchange this bed for mine at home. Hoping...

“It’s a long road, so we are just trying to stay focused and grounded and keep moving forward.  I’ll take it, though.”

Sturgill Simpson

Some Progress

So last night we increased his support settings on his ventilator and started steriods.  It helped, some.

This morning the decision was made to hold physical and occupational therapy since he really went downhill after that, continue steriods, lower his oxygen parameters (at cardiology’s recommendation) and to consider a transfusion tomorrow, you know, give him more little red blood cells to be able to carry that oxygen around.

All in all, it has been an okay day.  We haven’t had to bag him.  That’s a victory.  He’s still really high on his oxygen and his support, but the big bad vent is outside the room waiting for us to need it, and we haven’t.  He’s been tired and slept a lot, but that’s probably due to his almost all night party last night.  He’s happy.  I’ll take it.

Sorry it’s such a short update, but that’s pretty much what’s happening here.  We keep trying to move forward, one baby step at a time.

“We tend to forget that baby steps still move you forward.”

Author Unknown

Rough Day

Playing with music therapy on Monday

Aaron is having a rough time this go around.  

Yesterday it seemed like things would be pretty straightforward.  Kinda a “lather, rinse, repeat” thing.  Been there, done that, bought the t-shirt.  You know, same old same old.  

Today, not so much.  He’s been tired, sleeping quite a bit, and when he’s not sleeping, he’s not satting well.  As in, we’re back on 100% oxygen and spent most of the day hanging in the mid-70’s.  A couple times we dipped into the 50’s and 60’s.  Yeah, not so great.  

He seems to be moving good air in his lungs.  He’s not wheezy, although albuterol does seem to help, briefly.  They repeated the x-ray with the same results, a good thing, it opens up the possibility of using steroids on him.  

For now, we’re increasing his support on his ventilator.  If that doesn’t work, we’ll change to a bigger vent.  

But it’s kinda hard.  He’s happy, don’t get me wrong.  We’ve still got smiles and all his hijinks, pulling off leads, teasing, etc.  But still...

So what did I do?  I escaped briefly and had dinner with two other moms.  Two moms who are facing the same long-term outcome.  And we talked and laughed, and tried not to cry.  Gotta love people who just “get it” ‘cause sometimes, that’s the only way to keep from losing your mind.  (Okay, maybe too late for that, but you know what I mean.). 

Anyway, we’ve had the “talk” again.  And I “talked” as well.  There is no mistaking that we are still a full code, that if he doesn’t respond to the vent settings or the bigger vent, we’ll escalate from there.  There will be no giving up.  This kid still has way too much life and joy and goofiness going on.  We’re not giving up, no one is.  

But sometimes, sometimes it’s hard.  

"If you can't fly then run, if you can't run then walk, if you can't walk then crawl, but whatever you do you have to keep moving forward."

—Martin Luther King, Jr

Here We Go Again

Last night in the ER

Yep, we’re back, a month and a half after discharge.  Kinda rough.

This one hit us out of the blue, and I won’t lie, it made my thoughts go places no mama’s thoughts should go, mostly because I didn’t see it coming, not much anyway.

Aaron was good, really good, almost all week.  He went to all the concerts, one each night, and loved them.  No problems, no issues.  And being tired out, he slept well at night, too.

Until Friday, that is.  Friday started out like any other day, just fine.  There was a little more suctioning the night before, but our pollen counts are also sky high, so whatever.

And then his nurse called me at work from school. He was running a fever. 101.1  She was suctioning a lot.  He was seizing quite a bit.  And he was maxed out on his oxygen and still not able to maintain his sats.

The call came in one minute before my lunch break, so I quickly explained the situation to the front office and left, promising to be back as soon as I could, but it would probably take a little longer than my 30 minutes.  Raced over to his school, got him home, helped get him set up and went back.  I was a little late, but not much.

Then they asked me if my son was okay, if I was okay.  I didn't know, honestly.

Friday afternoon at home

We got the fever down and he slept, pretty much all night, from 1 pm to 7:30 am.  (Seizures will do that to you, wipe you out.). Still it was hard to keep him stable.  We have a big M-90 tank, the size that ambulances run with for emergencies.  We blew through that in less than 24 hours, and often when he wasn’t on it, we were bagging him.  We tried to stay home, we really tried.  Yesterday was Andrew’s last soccer game, there were things that needed to be done at home.  Graduation is coming up, dance festivals, etc.  But eventually I had to throw in the towel and give up.  

He’s resting now in the PICU.  It’s not pneumonia, my biggest fear.  It looks viral.  We’ll have to see how it all plays out.  At the moment, this very moment, he’s looking pretty darn good.  But he’s also asleep.  I’m sure that will change when he wakes up.  

So Tincture of Time and all that.  We’ll make it through this one, too.  Just needing more support than we can give him at home.  

Amazing what a kid will pull to get a “vacation.”  

                   Xray time

[M]an can accept pleasure only to the extent that he is willing to accept pain... 

the rejection of either eliminates both. 

~Thea Alexander

Living Life

My Superhero (badly in need of a haircut)

How has it been so long?  I keep having these thoughts racing round and round in my mind, and thinking, "Oh, I need to write about that."  And then I don't.  Something about work and kids and just life, you know.

It's been a busy month, but (mostly) in a normal, regular life type of way.  Two weeks ago, he was acting "off."  It went so far that one Tuesday at school, he was crying and had a low-grade fever.  I was a little concerned, but not much.   I know, right??  My kid crying with a fever and I'm not wigging out!  But I looked at what he'd been doing, great oxygen when upright, not so much in bed, not sleeping well, fussing with his trach ties, and wondered, ear infection?
 

Waiting for our prescription.

So I called his ped.  They didn't have any appointments available (funny how that happens when you call about 4 pm) so they put me in after hours.  We went, they were behind, we waited our turn!!  Again, who'd have thunk??  And yep, kiddo had an ear infection.  We went to the pharmacy, waited again, got that pink bubblegum medicine (too bad he doesn't taste it) and went home!!!!  You know, like a normal kid!

I know, I know, waiting isn't fun for anyone.  Except, sometimes, it is.

You don't wait when your child isn't breathing.  You don't wait when oxygen sats are dropping.  You don't wait if there's a possibility of things going south really fast.  Then it's all hands on deck.  I've been there as they've called a "red patient admit" to the ER, and it was us.  I've been there as they've called "rapid response" to his room, too many times.  I've taken that phone call when I've stepped away from the hospital briefly that begins with a deep breath, and they tell you what has gone down (and down is the right word).  Yeah, not much waiting there.  So waiting?  Yeah, it made me laugh, and almost cry.

He's doing well on his seizure med, we think.  Still seeing a few here and there, and wondering if I'm missing some.  See, they're pretty short, usually less than a minute.  But they also wipe him out.  The good thing is we haven't had to use his "rescue" med.  They've stopped on their own.

He's also been a bit of a punk from time to time.  A couple weeks ago, he threw a plug while I was gone.  Dad and Andrew worked on him, bagging him and suctioning while I raced home.  And Aaron?  Well, he may have a career in plastic surgery someday.  Dad is trying to save his life, and he's trying to remove Dad's nose, pull his hair out, and basically laughing at them.  Crazy kid!  I mean, who does things like that when they aren't breathing well?  My child, apparently.


Then last week, my niece graduated from BYU.  To celebrate, they invited family to come to the Gardens at Thanksgiving Point for the Tulip Festival.  Inside is a section called "Light of the World."  I have never seen this.  A beautiful rendition of scenes from the Savior's life, it was exactly what my soul needed. 

Awesome big brother pushed the wheelchair up hill and down.

Sometimes, things are hard.  And often the hardest times come when life is just flowing the way it's supposed to.  When we're not in crisis, I have time to think, to ponder, to try to make sense of things.  I'm reminded in small ways, and big ways, of the fragility of this life.  This week a girl, just shy of her 37th birthday, passed away after living a joyful life with T18.  Two weeks ago, Georgia was laid to rest.  Emilee and I sat and cried side by side at too many funerals, and then she was the one up front, while I was in the back.  It still isn't quite processing, and she isn't even my child.

But this evening in the Gardens, I found comfort.  The beautiful flowers were wonderful, and awe inspiring.  But as we entered this space, where there aren't many flowers, it's almost entirely xeriscaped, the first image was one from Peter's perspective after he's left the boat to try to walk to Jesus on the water, only to lose faith and sink.  And I was reminded, my Lifeguard walks on water, and He is always there.  He knows, He understands, and He loves me.  And because of that knowledge, I can find strength.

It is I.  Be not afraid.

Supervising basketball.  Love warm weather!!

We'll go on, making as many memories as we can.  Soccer games, impromptu basketball contests between brothers, haircuts and school.  Being silly and sleeping in late.  Trying new things, and even having "normal" experiences like ear infections.  We'll pack as much in to his life as we can, and by so doing, into ours as well.  Fill our cups to overflowing.  Because someday, those chances will be gone, and I don't want to miss out.

"Enjoy the little things in life, for one day you may look back and realize they were the big things."
~Robert Breault