springlakehomestead.com
An Aspiration Operation - Spring Lake Homestead
What started as a great day that Friday quickly turned into a nightmare, and it all started with a peanut. It wasn’t even a whole peanut, but half of one, broken into two pieces. Those two chunks of peanut nearly caused us to lose our baby. Friday, September 8th was Doodle’s 4th birthday. We woke up to a happy boy, watched him open gifts, and then spend the remainder of the day playing with his big brothers and sister and his baby brother. He was busy playing, so I took the time to work on cutting up apples for applesauce. We had some visitors come to wish him a happy birthday, and after they left, I headed back into the kitchen to finish the applesauce. I hadn’t been out of the living room where the kids were playing for more than two minutes when I heard E gagging. I ran into the living room, and he started coughing (a great sign right?), but something was obviously not right. He was wheezing, his breathing was shallow and rapid, and he was greatly distressed. On the floor in front of E, there was a peanut, broken up and wet. I didn’t take time to assess whether or not the whole thing was there or not. I tried patting him on the back, then giving him something to drink, and when neither of those things worked, I raced out of the house to take him to the ER. I had him sit up front in the van, which is not normal for him, but I was worried something would happen if I couldn’t keep him awake, and I couldn’t reach him if he sat in the back. (I think my rationale for driving him instead of calling the ambulance was that I could have him to the hospital in close to the time they would have first gotten to our house. Whether that was acurate or not, I have no idea.) The whole way to the hospital, my hand was on his cheek, gently shaking him awake, talking to him… I didn’t know what to think. Something was very wrong, but then again, he was still breathing. Was this an allergic reaction? He’d had peanut butter before, but never a whole peanut (I didn’t actually feed it to him, he found it on the floor). Was it more like an asthma attack? Maybe he aspirated some of the peanut? I did know. Why didn’t I check to see if that whole peanut was there or not??? When we got to the hospital, they brought us in promptly, first to a “standard” room for those who are just sick (among other things), and then to the ICU rooms where they have all of the stuff they need to do true emergency care. So many people came into the room. There were doctors and nurses and respiratory therapists… it didn’t help that there was a shift change not long after we arrived, making it more difficult to keep track of how many people actually needed to be working on our situation. We did oxygen masks, watched his numbers, x-rays… nothing was helping. The x-rays showed nothing. My sweet, friendly baby who loves everybody was suddenly terrified every time somebody new came up to him to help. I was just waiting for some kind of answer so I could tell Scott what was happening. After all, I had left who-knows how many hours before, and he was still waiting to find out if E was alive or not. At first, I thought this would be a quick fix, or at least I hoped it would be. I was expecting to get home in time for a late dinner with Doodles on his birthday. And then the doctor came into the room to tell me that we were going to be transferred to Children’s in Milwaukee and that an ambulance had been ordered to transport us. They needed to do a full bronchoscopy to see inside of his lungs, but they didn’t have the right equipment to do one on somebody so little. I called Scott to let him know. The ambulance and staff came, but they said he needed a breathing tube and could not be transported until one was placed. They couldn’t place a tube until they were sure there was nothing stuck in his windpipe. Even though they had done a neck x-ray and saw nothing, they knew that a peanut may not show up on the x-ray, so it was off to the OR. The nurse took me to the waiting room, me traumatized by leaving my very upset baby alone with strangers. You would have thought I was torturing him by the look on his face when I left the room. No news on how long this was going to take. I waited anxiously, pacing, shaking, crying, and praying over and over again. I called Scott to tell him what was happening. I cried some more and felt sick to my stomach. Finally, after close to two hours of waiting, the doctor came out. He said that “he’s okay…” meaning he’s not dead, but he’s in really bad shape. Then he told me that they didn’t find anything with the procedure they performed (they could only do a bronchoscope for the upper respiratory tract, up to the vocal cords) but there was likely something in his lungs, they were able to place the breathing tube, and the medi-flight from Milwaukee was coming up to transport him because the ambulance wasn’t going to be fast enough. He told me we could be there for days to wait for recovery. My stomach dropped and I started crying. I called Scott to tell him the latest, and this time asked him to come to the hospital. I was worried he’d never get to see E alive again. Scott made it to the hospital before the helicopter, and once the helicopter arrived, they still did not leave right away. He was not stable yet, and they needed him to be doing better before they could fly him out. (I found out later that his lungs were bleeding during this time.) Finally, he was brought out of the OR on the stretcher, tiny and looking nearly lifeless… discolored and too still. His chest was still moving, the only sign of life. Into the elevator they went, and we out to the car. In a way, we wanted to watch the helicopter take off, but we already knew that the helicopter would get to the hospital long before us, so we left right away to get a head start. Watching the helicopter fly overhead was unnerving. My baby was “alone” up in the sky. Scott reminded me that he was not really alone and that he had a great medical staff with him, exactly who he needed to keep him safe. Still, I couldn’t help feeling sad and anxious the whole way there. An hour and fifteen minutes later, we were at the new hospital… 10 minutes later we were finally in the room with him. Thank the Lord, it only took the helicopter 21 minutes to get to the hospital. What is normally a 30-minute flight was sped up significantly by a good tailwind. We only got a minute with him before they ushered us back out of the room. They needed to finish placing lines for drawing blood and for IV’s. They had done an x-ray and found that his right lung was partially collapsed. There was fluid buildup and inflammation. His condition was bad and worsening. They told us that it might get worse before it got better, and they were right. His heart rate was 185, he was barely getting any oxygen on his own, and his fever kept getting higher, getting over 103F. All of Friday night and into the wee hours of Saturday morning, we waited for his condition to stabilize. Finally, he was showing stability, and even the tiniest bit of improvement. The ear, nose and throat team came in to see him, and they performed a bronchoscopy to check for foreign bodies. Almost immediately, the doctor found a piece of peanut in the right lung. Suddenly the tension that had been building in the room turned to a wave of relief. They took the camera out and started to prepare the OR for the procedure to remove the nut. I cried tears of joy as Scott held me. While we waited, a chaplain came into the room to say a prayer with us. It was a beautiful prayer, and just what Scott and I needed in that moment. We kissed E goodbye as they wheeled his bed out of the room, and then we waited anxiously for the next 30 minutes. The doctor came back into the room looking excited. He showed me a specimen container with two chunks of peanut in it. He said that E had aspirated one chunk into each lung, and that was why he had been doing so poorly. A peanut is one of the worst foods a person could aspirate because of the fat content in the nut… the lungs secrete fluids to expel foreign bodies, but a peanut was too heavy to be easily expelled, and the fat mixes with the fluid in a way that causes extra inflammation. E was already doing better, and he was going to be okay, but he’d still need a lot of help for the next couple of days. Saturday was an odd day. It was filled with relief, but as the night wore on, my tension grew. He was improving, but not as fast as we had hoped. He had been on paralytics since leaving the other hospital, and after the surgery, they moved him to sedatives. He was still unconscious, but now he was starting to move and trying to wake up. We needed him to stay asleep so that the breathing tube would stay in place. His little arms were tethered so that if he would wake enough, he wouldn’t pull the tube out, and so that he wouldn’t move around enough to knock the tube out. All day Sunday, we took turns holding him down. Despite being unconscious, he was moving a lot. We found out during this time that red-heads require on average 20% more anesthesia and pain medications than their counterparts of similar stature. (This statistic is one I am glad to now know since 5 of the 7 people in our family are red-heads.) They struggled to find the right balance for him, and as Sunday wore on he became more and more restless. He was the most “active” when I would be away from the bed. If I stepped away to grab a drink of water or go to the bathroom, he would start thrashing. The hardest part was the silent crying. Turns out you don’t make any noise when you have a breathing tube in place. The good news was that he had started to improve a lot. They gave him some breathing treatments that are used on cystic fibrosis patients to help clear the lungs (it involves shaking the torso to loosen phlegm), and gradually, the lowered his help form the machines. His early morning x-ray showed some improvement in the lungs, and shortly after that, the breathing tube was out. Typically, they wean patients off of the medications, but he had been fighting them so hard and they did so little for him that they cut him off shortly after the tubes were out. He didn’t seem to mind and wasn’t in any pain, but he was shaky for the next two days. We spent the rest of the day Monday in the ICU snuggling for the first time since Friday. His first reactions were a smile for Dad and the word “Mama” over and over and over for me. I still couldn’t’ leave his side...