I was thinking of the danger of being born even before I got the message from my sister last night.
Last Sunday morning, I received messages that both of my sisters had babies overnight and were next door to each other at the hospital! I sympathized with the nurses, since my sisters married brothers who look alike and their initials are so identical.
Both babies were doing fine, breathing on their own, that miracle that happens every time a baby is born. Both big sisters were in love!
Vince Edward with sister Mya
After heart surgery, everyone comes out on a breathing tube. The nurses and doctors never want to extubate (take the breathing tube out) until they’re convinced the patient will fly on their own.
There comes this moment that the nurses and respiratory therapists gather around the bed and pull the tube.
“Breathe! Breathe! Breathe!” You’ll hear voices shouting from across critical care.
This week, thinking of my sisters’ new babies, I thought of the similarity between resting on the breathing tube before extubation, and resting safe and secure in your mother’s uterus before birth, depending on her heart and lungs.
Both extubation and childbirth are good things, signs of progress. If a patient never gets extubated, they die. If a baby never is born, they die. But the truth is, the hard part doesn’t start until you are off the support of someone else’s lungs and breathing on your own.
Usually people’s lungs kick right in, and they are able to be independent.
But not always.
Once, Dr. Halloran and I were walking leisurely back to crictical care when we met the critical care doctor sprinting out of his office.
“Who’s in Room 14?” He asked.
“The patient we just extubated,” I said.
“They’re coding,” he said, running toward the room, as staff flocked in with equipment and someone started chest compressions.
Everything was fine in the end, but the truth remains: becoming independent of breathing support, whether after heart surgery or after birth, is both an exciting time and a scary time.
With these things in mind I wrote down “Extubation & Childbirth” for my Saturday night blog. Beautiful things, yes, but moments of truth and pain, and sometimes the realization that something is not yet right.
My thoughts of what I should write in my blog were still in process when my sister Kelsie sent us a message that Dr. Schrock was sending her newborn, Lucia, to urgent care because he couldn’t find pulses in the femoral arteries in her legs.
We weren’t sure if it was a big deal, but a few hours later, Kelsie informed us that little Lucia was admitted to the NICU with impending heart failure and would soon be transported to Milwaukee for surgery to correct coarctation of the aorta, a narrowing of the main artery to the lower half of the body.
Symptoms of this condition, I discovered after pulling down my pediatric textbook, are heart failure in 7-21 days after birth, and absent femoral (leg) pulses. Apparently, the heart, still strong from its mother’s support, has enough strength to push against the narrowed blood vessel for a few days, but finally tires of its independence. Even by Friday night, Kelsie said, her heart was showing signs of exhaustion.
What a blessing that Dr. Schrock caught the absent pulses before the heart failure set in!
“We need to go for surgery at Milwaukee sometime soon to fix the problem,” Kelsie said next. “She has to stay on the medicine until surgery. So we’re looking at an extended time away from home… apparently by tonight or tomorrow she would have been getting quite sick.”
This morning: “They are getting ready to put her on a ventilator for transport in the helicopter because of a side effect of the medicine is a risk of pausing breathing….now the helicopter guys are saying no flights today because of the weather. Discussing plans of ambulance or waiting.”
And then, packing up little Lucia for the ambulance ride:
I work in heart surgery, but not with babies. Adult cardiac surgery is completely different, if for no other reason than that a baby’s heart is the size of a strawberry. It’s hard to imagine tiny little Lucia, who I have never met, being put on a breathing tube and prepped on the operating table.
Please pray for Lucia, her big sister Alaina, and her parents Jay and Kelsie Troyer as they settle into the big hospital in Milwaukee. And pray that she will have understanding nurses, a skilled surgeon, and a nice slot on the surgery schedule without too much waiting… and like our patient who didn’t fly right after they got off the breathing tube, let’s pray that in the end, everything will be all right.
Safe arrival in Milwaukee, with escort by my sister Kristie and her husband Sheldon, who came up to see the babies.