Monday, April 15, 2013

Surgical Suite: Allegretto con moto*

Saturday was another gloomy, rain soaked day.  I did not make it into the ward for rounds as I had to eat, pack up and check out of the Fortress of Solitude.  I then put the lug in "luggage" as I made my way to the hospital.  I hoped that the promise of a private room (with a bed) would come to fruition;  if not, I would be making up a bedroll on the floor at Wyatt's bedside.  I have actually slept on the rough side of a rock... and every kind of stretcher, bed, day bed, pull out, couch or big chair that a hospital can offer.  I can do it, but I am not as young as I used to be and my wishes for a bed was totally with my aching bones in mind.

As I got off the elevator on the fourth floor, I was momentarily confused with what I was seeing in front of me.  As I kept walking, I realized that the doors of the unit had shut;  I assumed that there had been a drill and that the magnetic locks had closed the fire doors (as they did in my hospital).  As I wheeled my leopard print bag even closer, I realized that there was a note on the door:




I pushed my way past both sets of doors, hitting the handwash station on the way.  I went straight to the desk and was greeted by an unsmiling person wearing a yellow isolation gown.  I identified myself and asked "what kind of outbreak?"

"Rotovirus", she answered, just as unsmiling.  I think I swore and made my way to my son's side.  I was very relieved to see that there was no isolation signage outside his quad room.  He sat up immediatly and looked extremely happy to see me.  We had a series of long hugs and tickles which tided us over (and settled my 'outbreak anxiety') until his nurse introduced himself.  I also had to call Sean and tell him to not bring the kids, which made me very sad and homesick.

There was a lot of activity in the halls.  Patients were being moved around and nurses were rushing about their day.  With the outbreak precautions however, you could tell that there was an added level of urgency about everything. Discharged patients had to be gotten OUT.  Patients that needed isolation had to be sequestered to one area of the unit.  Somewhere in there the Charge nurse dropped by and asked if I thought we would be comfortable going home TODAY, in lieu of the circumstances.  I conferred with Sean via phone and talked to both Wyatt's nurse and NP and we all decided that staying another night was a very good precaution, especially since his drains were still in and I knew that their removal was going to be a bit of an ordeal. 

Shortly after, we started moving ALL THE THINGS to our new room.  I busied myself with setting up before going back to help push a sleeping Wyatt and his crib to his new digs.  They had given him some morphine in anticipation of drain removal later.   He woke up with the motion of the bed and started crying again, but settled once he figured out that we were on a bit of an adventure.

He was barely in his new room when it was time to pull his drains.  This is an added skill, one which Wyatt's nurse had not achieved yet.  As a result, several people were planning to be present (and we had to ask for more to help hold him down).  I was hoping that my meeting of family downstairs for a quick coffee would coincide with this so that I could have an excuse not to be here;  sadly, everyone arrived and Wyatt looked at me with tearing, terrified eyes at all the yellow gowns and splash guards.  I couldn't leave him.

Each of the Jackson-Pratt drains (there were two) were sutured in heavily, with coils of suture around the "base" of the tubing (near the skin) for stability.  If the drains had been pulled out, they would have caused a pneumothorax, so the drains were put in as securely as possible.  I was at Wyatt's head and holding his hands as the area was first cleaned with Betadine and the coils undone.   I sang softly into his ear, something that I was told later made all the difference for everyone.  Before she began, the charge nurse asked me softly,

"Jen?  Have you ever seen or done anything like this?"

I answered her over my son's chest that I hadn't ever seen this one done and I certainly hadn't pulled any drains in a very long time.  She nodded and quickly told me what to expect.  Pulling the drain itself would hurt, but the area where it had pulled from and the path it had taken would burn for several minutes afterwards.  Wyatt was going to be in a lot of pain, which is why they had given him the morphine an hour before (so that it was well "on board").  I resumed my quiet singing, trying to keep my voice even as my eyes overflowed and betrayed my calm.  I had to change songs two or three times as the pulling began and my son's cries turned into screams.

I could see the charge nurse's eyes getting very wide as she pulled abruptly on what seemed like miles of tubing. My voice kept cracking and he looked like he had been punched in the abdomen. I turned my eyes back the Charge nurse just in time to see the end of the tube finally come out, followed immediately with a jet of sanguinous fluid that made a squiggly line up her gown and over her visor.  She quickly removed the second drain and applied pressure.  Wyatt was gasping for air in between screams, his eyes a bright green and focused on the ceiling.  A pressure bandage was applied quickly, the oxygen saturation monitor was put on his toe and I carefully scooped him into my arms. I hugged him tightly as the staff respectfully cleaned up quickly and left us.  We both cried for a moment, before I resumed my singing and calming him once more.

He settled a few moments later and was happy to veg out to some television.  After a quick trip to the bathroom to let out a few more sobs, I left Wyatt in the charge of his nurse who was kindly telling me to take a break and to take my time with it.  I went downstairs to meet up with family;  we had a very short visit, but it was well timed.  I was grateful.  I went through the cafeteria to try and find a few things that might entice him to eat, grabbed a salad for myself and headed upstairs once more.

Wyatt was asleep, so I got out the laptop and wrote for a short while.  On his awakening, he seemed to have finally found his appetite.  Maybe removing all those drains made some room, who knows?  He quickly polished off 150 ml of juice, half a banana, a fruit cup, half a boiled egg and some grated cheese.  Later he would have 275ml of juice and a yoghurt, but turned his nose up at his bedtime bottle.  It was amazing to see this transformation.  I took the monitor lead off his toe for the last time, noting that his sats were consistently between 96 and 99.  Wyatt was completely pink and looked more like his Sean and his ruddy ginger-ness every minute. 

The rest of the afternoon and evening was spent wearing his own jammies, watching TV, napping and playing with Scout, the caterpillar and the "coo coo bébé!" thing.  He talked to the other kids and Daddy on the phone, all the while petting the beard on the picture of Sean on my phone.  By 10 pm my eyes were closing but he was still partying on.  He would drift off to sleep but then unit noises would wake him up or he would stir, or it would be time for more medication and the subsequent calm down after that.  I turned the TV off at one point and he just lay there and whimpered, moving his jingle lion quietly back and forth.  It suddenly occured to me what was wrong:  there was no music.  Since they were born, they have slept to the sound of a radio, to give a little background noise and comforting sounds.  I quickly set up the laptop and we both drifted off listening to Nights with Alice Cooper.  It played until the wi-fi timed out, but by then we were both long asleep. 

There was a lot of movement this day, some of it smooth and transitional, some of it rough and laborious.  We were so much closer to going home:  off oxygen, drains and lines out, eating and drinking.  We still had to make sure that his bowels were working, that his pain was controlled and that the Lasix was working to remove the excess fluid.  With a bit of luck, tomorrow would prove to be the last part of this opus.  We were both weary and eager to rejoice in the final fermata**.

*Allegretto con moto - musical term meaning "moderately fast" (Allegretto) "with motion/movement" (con moto)
**fermata - the final note of a movement or symphony.  It is often held for dramatic effect.  

The Surgical Suite:
Prelude - Grave - Allegro con brio - Adagio - Allegretto con moto - Finale - Coda


  1. I've had this post open for the whole day. Just sort of mulling over this whole experience for you. What really stands out for me is that I'm so glad I'm seeing you taking those last steps on the bridge and putting it well and good behind you. And Wyatt's ruddiness. Now I'll forever think of him as the 'ruddy kid'. Hope you're happy ;-)

    1. Thanks. It wasn't pleasant in spots. I have to be honest about that. It is the nature of the beast. However, if a few moments make for a happier kid, then it is totally worth it. I'm slowly putting it behind me.

      I was also considering leaving the drain part out, but I felt it needed to be told. Information is a good thing and if a parent knows ahead of time that maybe getting 5 minutes of fresh air or a coffee right about then is a good thing, they might be spared that (and get to walk in a few minutes later and be the hero).


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