Reflections following a life-threatening illness

I’ve said before that one of the goals of my writing is to offer encouragement to families receiving a diagnosis of Down syndrome. When you’re new to the world of Trisomy 21, there’s so much to absorb, and unfortunately it’s virtually all negative. It’s not a conspiracy—it’s just the nature of medicine. They study the pathology of things; anything to the contrary is subjective and emotional. In other words, human.

 It’s the human face that I want to put on the experience of parenting a child with Down syndrome, in order to counterbalance the overwhelmingly scary information that is all you get when you get the DS diagnosis. I try to focus on the laughter, the warm fuzzies, the beauty of life with DS.

 So how do I reconcile optimism with the need to be honest?

Because let’s be honest, without modern medicine…breathing tubes, feeding tubes, a slew of pharmaceuticals, and exceptional doctors and nurses…Julianna would be dead now. Twice. And she’s only two.

 It’s not something you want to think about when you’re standing at the ER admission desk. The woman behind the desk takes one look at your daughter and leaps to her feet. “Give her to me,” she says. “I’ll take her back while we do paperwork.” She’s hardly panicking, so it’s not till later that you realize what her haste means. About the time the EMT comes out wearing a grave expression and says, “Mom, come back with me.”

Suddenly all the choices I made that day flash before my eyes. Errand running. Sitting out on the swing, hoping that if I ignore her horrific crying, she’ll go on and go to sleep and get some rest. Nursing Nicholas on one side before going to the ER. The time wasted getting Alex dressed before we could go.

 Having a child with special needs is stressful at times. For some parents and situations, it’s probably most times. But the experience changes you—for the better. Parenting the special needs child is a purifying fire, to be sure, and walking through fire is never enjoyable. But love is not limited to the whole and the “perfect,” and those who begin life whole and perfect may not remain that way, as J.K. Rowling observed.

 Of course, philosophical reflection is small comfort when you’re spending two weeks in the hospital for something that other kids could kick in five days. These last two weeks, I have come to understand why kids with Downs didn’t live long in generations past. By early Tuesday morning, the simple act of breathing was draining Julianna’s body. Without the vent, she would have exhausted every scrap of energy she had left, and then she would have died.

 So, joy and love, tempered by realism, is the message of the day. The thing is, every child causes you pain and anguish and frustration and hair-pulling moments. Every child also causes you unparalleled, heart-catching wonder and joy, moments of tremendous beauty and thankfulness. It’s just that some children cause frustration by biting or throwing tantrums, and others do it by getting sick and landing in the hospital for two weeks. My point is that a child with Downs (or any other special need) is more like her typically-developing siblings than she is different. The challenges are there, but if you focus on the black clouds, you’ll miss the rainbow superimposed upon them.

A reminder I need today, in the midst of post-hospital backlash and an infant who finally succumbed to the germs floating around, and got sick.

 Sigh.

Published in: on May 18, 2009 at 5:22 am  Comments (1)  
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We Now Return to Regular Programming

How nice, to actually (gasp!) skip a day on blogging!

I close out this chapter of our lives by sharing some pictures.

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Julianna PICU crib   Julianna balloons

Scenes from the PICU, 5-4-09 through 5-15-09, and homecoming 5-15-09

Published in: on May 16, 2009 at 9:05 am  Comments (1)  
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I heard a rumor ….

… that we might get to take Julianna home …… TOMORROW (as in Friday)!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Here’s more of Christian’s nightly update:

We have moved 150 feet down the hall and are officially OUT of the Pediatric ICU and on the regular pedatric medical ward. We’re down to two monitors and one IV line that is not currently in use. Although, because it is in her jugular vein, it’s actually sewn into her neck, which is going to require a little doing to get it out (unless Julianna decides to just rip it out at some point – which is pretty much what she has done with everything else).

And my last thought for the evening – for those of you who have had an opportunity to see the latest Star Trek movie – you know the big red monster that chases Kirk on the ice planet about midway through the movie? – that’s Julianna in the morning when she wants breakfast. (Just imagine the roars a little bit louder and you get the idea.)

Looking forward to some joyful chaos at home in the near future.

Have a peaceful evening.

Published in: on May 14, 2009 at 9:41 pm  Leave a Comment  

Of Patients and Patience

He leaned on the foot of the crib, watching Julianna while he talked to me, just as he has for the last…well, I think it’s six days now (it’s all running together)… explaining why he had ordered the nurses to slow the process of weaning Julianna off dobutamine, and thus keep us in the ICU for another 36 hours. I sighed and nodded resignation, and he turned kind eyes on me. “Thank you guys for being so patient through all of this,” he said.

“W-well,” I stammered, wondering if my lack of patience was broadcasting clearly enough that he was reacting to it, or if I’m just a good enough actress to make him think I actually am patient. “Umm…thank you for everything you’re doing for her.”

Our family has now dealt with eight hospital admissions/stays in four years, beginning with the birth of Alex in 2005. Luckily, most of them have been relatively short and easy to predict: three C-sections (4 days), a burn treatment (outpatient), heart surgery (4 days) and an overnight for croup. It’s just Julianna’s two major illnesses that have stretched on and on, the ground constantly shifting beneath our feet, so that we can’t plan our life. And let’s face it, Christian and Kate Basi really do plan everything.

Time in a hospital is a very amorphous thing. You spend most of it waiting—waiting for the doctor to come in, or the other doctor to come in, or the results of the test to come back, or for the numbers to improve. Waiting for answers, especially to that most important question that no one can answer: “When do we get to go home?” For a few days, you can plan projects and be very productive, but after that, staring at the same four walls and the same beeping monitors numbs the brain. The hours slide by from one meal to the next, and despite being hyper-aware of the clock, you lose all track of the day of the week.

Being a patient (or a patient’s parent) requires patience. And a lot of it.

Until today, I never processed the double meaning of that word: patient. Right before Julianna turned the corner, I kept thinking, “What am I doing wrong here? Am I not praying hard enough? Am I using the wrong words? For goodness’ sake, we have the entire city of Columbia praying for her, and multitudes outside it as well. If that doesn’t qualify us for speedy recovery, what does?”

Now, having sat through Julianna’s second life-threatening illness, I realize that the first was no fluke. When she gets sick—not cold sick, but really sick, I mean—we’ve just got to expect that recovery is going to take twice as long as it ought to. Chances are, it’s in the chromosomes. Her RSV stay was ten days. This one is ten days and counting. I guess we just have to brace for that, and pray that she’s about through that age where kids get life-threatening illnesses.

Well, in any case, we expect to be moved out of the ICU sometime this afternoon. On to Phase II of the hospital stay. Please God, it won’t be very long!

Published in: on May 14, 2009 at 2:56 pm  Comments (1)  

Almost There

When I came in this morning, the flow-pap was gone. After bath this morning, my baby girl’s cheeks are kissable again– IOW, not covered with tape and second skin and tubing. She has figured out that if she fingers her IV tubes and starts tugging, Mommy will pay lots of attention to her. Yee-haw. (Remember that this is no ordinary IV; it’s in the jugular vein!)

However, they’ve slowed the weaning of the blood pressure meds to every 12 hours, so now it’s mid-afternoon tomorrow before she’ll be off all her meds, and sometime after that before we get to leave the ICU. But Christian’s boss is back and gave him tomorrow and Friday off, so that will ease the stress. As does Meghan, our respite provider, who is sitting with Julianna outside of her finals schedule. And tomorrow night Christian and I are going out on a date.

It seems horrible to me to do such a thing. I think of my parents, who virtually never went out on dates, and I keep fearing that we will be judged for abandoning our children in a time of need. And yet the spousal relationship is first in the family–the origin of the children and thus, the most important. The transition period, caring for three while juggling everyday life, had already left us hanging on to connection by a thread. We expected the transition to be tough, and we had been living with our nose to the grindstone, barreling through as best we could and waiting for the craziness to settle into routine. It was starting to happen, too…and then Julianna went into the hospital.

Since then, what little conversation we’ve had has been logistics and progress reports; touch is nearly nonexistent, in any form. For a time, a marriage can handle that without negative effects, but for us, at least, that time is now past. So we’re going out, despite my uncomfortable sense that couples have survived far worse without thinking they have to go out on dates. Oh well. Count it as another blessing and get on with it already, Kate. Sheesh.

Published in: on May 13, 2009 at 12:10 pm  Comments (1)  
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Quickly

Yesterday, Julianna continued to scream at me all afternoon, refusing to sleep even though her little eyes kept rolling up into her head with exhaustion. (The nurses think it may be withdrawal from the monster doses of sedatives she was on.) It was annoying, but nonetheless, good news, because she had the energy to sit up and gripe. And it was all a show for Mommy’s benefit, obviously, b/c after I left for dinner, she stopped screaming and sat in her crib and played, and waved at her royal subjects whenever they stood outside her room.

Today the screaming soon stopped being so cute and instead began to shred my nerves, which is, of course, her intent. Like me at the doctor’s office last Monday, she’s trying to see if she can cause enough misery in her captors that they’ll let her go. If only it worked that way, honey. No, she has to stay in her ICU crib until she’s weaned from her blood pressure meds and her oxygen support has been significantly diminished–Thursday at least. Then we spend some unspecified amount of time out on the main floor before we finally get to go home. Well, that’s the breaks. At least I get to take her home. Someday.

I have not posted till this evening b/c  between the two of them–Julianna and Nicholas–I couldn’t sit at the computer long enough to accomplish anything. It kept shutting down on me. Hospital productivity is done.

Published in: on May 12, 2009 at 7:25 pm  Comments (1)  

Looking Up…tentatively

Julianna spent the entire morning screaming. Those who have ever heard her get mad at her brother know the sound I’m talking about. She did not take a break from the time I got here until after 1p.m., except for ten minutes when I think  she actually slept. Just one breath after another, AAAAEEEEHH! It wasn’t as bad as it sounds, because the torture device, pardon me, the bi-pap, muffled them almost completely. (If that tells you anything about this horrible invention.) Her heart & respiratory rates were sky-high. But it was an improvement nonetheless b/c it was MAD screams, not panicked screams like yesterday. However, mad turned to panic every time we messed with her death mask, excuse me bi-pap. The usual masks wouldn’t fit her head, so they put this hard rubber thing on her, with hard rubber straps that, by this morning, had caused a lesion on her left cheek from all the thrashing, and were well on the way to putting another on her right cheek. This despite the second-skin stuff they put underneath it to try to cushion her skin.

The X rays indicate that the pneumonia is more or less off the radar now, meaning it’s not really the issue; the issue now is viral, they think–it’s affecting her heart, which is not pumping hard enough, so fluid is backing up into her lungs. This means they have to keep her air support under pressure, so that the pressure in her lungs is sufficient to force the fluid out. Hence the bi-pap–that’s what it does; it seals around the nose & mouth  and forces the air in.

Anyway, all of this is simply to illustrate where we WERE, versus where we now ARE. I’ve spent little time online today b/c I’ve been caring for kids, and that’s probably a good sign. I had to push for some sort of cushion on the rubber straps, to protect her poor beautiful face, and I pushed for some sort of change in the regimen, because I was sure she wasn’t going to get better as long as she was screaming instead of resting.

Dr. Downs came in and we talked about options, and he called in Dr. Burny, who of course treated her all last week, and between the two of them they decided to take the bi-pap off again, and again, see how she did. And by now it was critical for her to have some food, b/c the feeding tube came out three days ago and she’s had nothing but a spoonful of jello since then.

That was two hours ago. She’s starting now to get agitated, but her numbers look pretty good, actually, so it’s hard to say whether she’s headed for respiratory distress again, or if she’s just pissy because she’s starting to feel just enough better that she can make everyone else miserable. :) She’s been signing “all done” all afternoon. The nurse said, “Maybe she just wants to make sure we know she’s done with the mask.” I second that…especially after she yanked out her flow-pap (the nose things) and signed “all done!”

We brought in water and ice cream at the same time. Practical Mommy, caregiver, had the water and got roundly rebuffed, while she lunged for Daddy, who naturally chose to carry the ice cream. Hmph. But Mommy redeemed herself later on by bringing cheddar cheese. :)

Her blood pressure dropped quite a bit last hour but now is coming back up, so for now, things look good. We continue to be profoundly grateful to you all, even though I guarantee we will never get thank you notes out. Sorry!

Published in: on May 11, 2009 at 3:15 pm  Leave a Comment  

The Hospital Blues

My van smells like the hospital, my clothes do too,
Haven’t slept with my hubby in what seems a week or two,
Been sittin’ in the same chair so long, I think my butt’s turnin’ blue
Twiddlin’ my thumbs and singin’ the hospital blues.

My baby’s bored from sittin’ all day in the P-ICU,
My toddler’s screamin’ bloody murder But whatcha gonna do?
She’s gotta wear the ?*#@!! mask if she’s ever gonna improve
Twiddlin’ my thumbs and singin’ the hospital blues.

Sorry, folks, I was hoping for a third verse but I’m all out of clever wit. Christian can add a verse tonight, I’m sure. :)

Published in: on May 11, 2009 at 9:43 am  Comments (3)  

Julianna update — an explanation to the madness

(Christian with his nightly report) I hope I can make sense with this short description. Following a suspect x-ray, one of the doctors ordered an echocardiogram, fearing some potential heart failure that may have been related to her hospitalization. Based on a preliminary report, the doctor believes that the virus responsible for the croup may also be affecting how her heart is pumping. If this is true, it would explain the roller coaster results the past 48 hours.

The good news: at this point, and keep in mind that any medical professional will qualify any statement with “at this point” (nothing is EVER set in stone), it appears that any heart problems are probably temporary. (Frankly, that’s the best scenario, so that’s what I’m going with!)

The bad news – as Kate stated before, is that Julianna is back on the bi-pap and hates it. She’s very uncomfortable, but all the nurses and doctors are doing everything they can to calm her and comfort her. But there’s only so much you can do when you have 6 monitors attached to your body from head to toe, 1 IV (With four different tubes) stuck in your neck and a mask the size of half your head strapped around your skull.

And another huge thank you to the folks who helped this weekend! From those who sat in the ICU with J, so the rest of us could spend some time together, to those who mowed our lawn (and arranged for it to happen), ran errands, provided prayers and emotional support – we owe you a great debt.

Have a peaceful evening.

Published in: on May 10, 2009 at 9:16 pm  Leave a Comment  

Skewered on my own eloquence

Three weeks ago (has it been so long already?), I gave a retreat presentation on music and spirituality. During it, I spoke of music as a way to help us express the whole range of human emotion—both positive and negative—in a prayerful way. The example I used was “Hold Me, Jesus,” by Rich Mullins.

It’s a great example of praying through pain and difficulty. The trouble is that, like everyone else, I’m more willing to philosophize about it, in the abstract or after the fact, than to embrace it when it smacks me upside the head. This morning, Mass felt like God knocking on my head saying, “Hello? Kate? Are you listening? Every branch that bears fruit, I prune so that it bears more fruit.”

Well, God, I feel the pruning shears, but I’ve got to be honest, I’m not grateful. Not yet, anyway. The way I see it, you keep piling things up till I think I can’t possibly hold any more. Why now, just when we thought we were coming to the end of the worst busy-ness and stress? In the middle of planting season and the end of legislative session, so my parents can’t come, and right around that storm that tore the heck out of Southern Illinois, so Christian’s parents can’t come? When there’s a reception after work on Monday, so Christian has to stay late? When it’s the end of the school year, so we’re feeling pressured to figure out how to have lessons, so we can actually have recital on Friday?

Every night, I go home and spend the entire time making phone calls figuring out what to do with Alex the next day. I have to shunt him from one place to another. Not that I’m ungrateful for the help, mind you, but I feel like I’m neglecting him. Okay, let’s be honest, I am neglecting him. It’s the nature of the beast. Right now, there are two other kids who need me more, and that’s just how it goes. But it’s one thing for it to last a couple of days. A couple of weeks at the bottom of the totem pole? This can’t be good for him. And I am sick and tired of not being able to spend time with my husband! What a sucky Mother’s Day! And what the heck is up with this gorgeous weather that I can’t enjoy because I’m stuck in the PICU?  And why does Nicholas have to pick this time to decide he just doesn’t care to eat?

Condensed like that, it just sounds whiny­—even to me. I should be grateful that Julianna’s not fighting for her very life; that we have such great friends and family who are inconveniencing themselves to help us; that I have a husband who will sleep in the PICU so I can sleep at home with Nicholas… But I keep staring down the barrel of another week in the hospital, knowing that homecoming is not going to mean the end of the hospitalization-related stress. However well-behaved Alex is now, there’s going to be a backlash later.

In this context, the song is all the more apropos. At least I can admit it, even if I’m not ready to pray it.

Hold Me, Jesus/Rich Mullins

Sometimes my life just don’t make sense at all
When the mountains look so big and my faith just seems so small. 

Hold me, Jesus, ’cuz I’m shakin’ like a leaf
You have been king of my glory; won’t you be my prince of peace?

And I wake up in the night and feel the dark
It’s so hot inside my soul, I swear there must be blisters on my heart

Hold me, Jesus, ’cuz I’m shakin’ like a leaf
You have been king of my glory; won’t you be my prince of peace?

Surrender don’t come natural to me.
I’d rather fight you for something I don’t really want
Than take what you give that I need.
And I’ve beat my head against so many walls,
I’m fallin’ down, I’m fallin’ on my knees.
And the salvation army band’s playin’ this hymn,
And your grace rings out so deep, makes my resistance seem so thin

Hold me, Jesus, ’cuz I’m shakin’ like a leaf
You have been king of my glory; won’t you be my prince of peace?

***

Christian tells me I need to update. Let me add to the story of the medieval torture device. It’s actually a “bi-pap” not a “c-pap,” and I was here during the spiral down into chaos that ended in the mask being strapped around her head. It looks like a Hannibal Lecter thing. Literally. And Julianna took it as such. I was sitting on the PICU crib, lying across her legs, holding her hands down, while she shrieked in panic and hurled her head around, trying to escape. I kept asking the RT (respiratory tech) if I was in the way, and she said “No, you’re doing fine.” That is, until I became vaguely aware that there were people all around me. “Should I get out of the way?” I asked again, and this time someone said, “Yeah, why don’t you step out for a minute?” It wasn’t till I stepped back that I saw there were six people working on my daughter. A crowd in an ICU room is a bad sign. I freaked out. A few minutes later I was crying.

This morning after Mass, when I came into the room, she was just waking up. The staff was preoccupied with a screaming patient next door, so when the noise woke Julianna, I was flying solo to try to calm her down. She fought the mask, she thrashed and panicked some more, I soothed her to sleep, she woke up and we repeated the procedure. And then she put her arms out to me. I started to gather her up, but the tubing and joint on a bi-pap are much less secure than I realized, and suddenly this pressurized thing fell apart. Sensing imminent victory, Julianna threw her whole body into the fight. And won. Dr. Downs came in (yes, ironic as it is, that is his name) and removed the bi-pap. So now we’re back to the forks in her nose (I’m sorry, as much as my medical vocab is expanding, I haven’t got that one in my head yet, it starts with a C and sounds like Calendula, but I can’t get the whole thing right). And now we’re waiting for her breathing rate to slow down so we can start giving her food.

Dr. Downs came in a while ago and leaned on the crib rail, studying her and the numbers. Then he said, “Little girl, you’re just gonna keep limping along till you feel better.”

That about sums it up.

Update as of 3:45 p.m. We’re back on the bi-pap, and talking re-intubation. The staff thinks we extubated too soon.

Published in: on May 10, 2009 at 12:55 pm  Comments (2)  
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